Therapeutic and diagnostic methods relating to cancer stem cells

ABSTRACT

The present invention relates in part to the discovery of genes that are deregulated in cancer stem cells (e.g., melanoma stem cells). In some aspects, methods for treating individuals having melanoma are provided; the methods involve modulating (e.g., inducing, inhibiting, etc.) the activity of the cancer stem cell associated genes. In other aspects, cell surface genes that are upregulated in melanoma stem cells are targeted for the selective isolation, detection, and killing of cancer stem cells in melanoma. Other aspects of the invention relate to reagents, arrays, compositions, and kits that are useful for diagnosing and treating melanoma.

RELATED APPLICATION

This application claims priority under 35 U.S.C. § 119 from U.S. provisional application Ser. No. 61/114,490, filed Nov. 14, 2008, the contents of which are incorporated herein in their entirety.

FEDERALLY SPONSORED RESEARCH

This invention was made with Government support under Grant 5R01CA113796-03 from the National Cancer Institute. The Government has certain rights to this invention.

FIELD OF INVENTION

The present invention relates in part to methods for treating individuals having cancer. The methods involve modulating, e.g., inducing or inhibiting, the activity of genes that are deregulated in cancer stem cells. In some aspects, cell surface genes that are upregulated in cancer stem cells are targeted for selective isolation, detection, or killing of cancer stem cells in melanoma. Other aspects of the invention relate to reagents, arrays, compositions, and kits that are useful for diagnosing and treating cancer.

BACKGROUND OF INVENTION

Self-renewing cancer stem cells (CSCs) initiate tumours and drive malignant progression by generating and supporting replication of more differentiated non-stem cell progeny. (M. Al-Hajj, et al., Proc Natl Acad Sci USA 100 (7), 3983 (2003); D. Bonnet and J. E. Dick, Nat Med 3 (7), 730 (1997); C. A. O'Brien, et al., Nature 445 (7123), 106 (2007); L. Ricci-Vitiani, et al., Nature 445 (7123), 111 (2007); S. K. Singh, et al., Nature 432 (7015), 396 (2004); T. Schatton and M. H. Frank, Pigment cell & melanoma research 21 (1), 39 (2008)). The mechanisms by which CSCs cause tumour formation and growth and the potential role of CSC-specific differentiation plasticity in tumourigenicity are currently unknown. We recently identified a subpopulation of CSC based on expression of the chemoresistance mediator ABCB5 (ATP-binding cassette, sub-family B (MDR/TAP), member 5) (N. Y. Frank, A et al., Cancer Res 65 (10), 4320 (2005); Y. Huang, et al., Cancer Res 64 (12), 4294 (2004)) within human malignant melanoma (T. Schatton, et al., Nature 451 (7176), 345 (2008)), a highly aggressive and drug-resistant cancer. (T. Schatton and M. H. Frank, Pigment cell & melanoma research 21 (1), 39 (2008); L. Chin, L. A. Garraway, and D. E. Fisher, Genes Dev 20 (16), 2149 (2006).) ABCB5⁺ Malignant Melanoma Initiating Cells (MMIC) correlate with clinical disease progression and can be specifically targeted to abrogate tumour growth. (T. Schatton, et al., Nature 451 (7176), 345 (2008)). Consistent with these findings, the ABCB5 gene is also preferentially expressed by in vitro self-renewing melanoma minority populations (G. I. Keshet, et al., Biochem Biophys Res Commun 368 (4), 930 (2008)) and by melanoma cell lines of metastatic as opposed to primary, radial growth phase tumour origin (J. F. Sousa and E. M. Espreafico, BMC cancer 8, 19 (2008)).

SUMMARY OF INVENTION

The present invention relates in part to the discovery that a number of genes (referred to herein as CSC-associated genes) are deregulated in cancer stem cells. In some aspects, the invention relates to diagnostic arrays and methods for detecting cancer in an individual based on the expression of CSC-associated genes. In other aspects, the invention relates to methods useful for treating individuals having melanoma based on modulating the expression and/or activity of CSC-associated genes. Compositions and kits that are useful for the foregoing methods are also disclosed.

The invention, in some aspects, provides methods for diagnosing cancer in an individual. In some aspects, the methods involve determining an expression level of a cancer stem cell (CSC)-associated gene in Table 5 in a test sample from the individual and comparing the expression level of the CSC-associated gene to a reference value, wherein results of the comparison are diagnostic of cancer. In some embodiments, the cancer is melanoma, breast cancer, prostate cancer, colon cancer or renal cancer. In some embodiments, the test sample is a tissue biopsy. In some embodiments, the test sample is a skin biopsy. In some embodiments, the test sample is a sample of the cancer, such as a tumor biopsy. In some embodiments, the methods involve updating a patient record for the individual to indicate the diagnostic result of the comparison. In some embodiments, determining comprises detecting in the test sample a mRNA that is encoded by the CSC-associated gene. In some embodiments, determining comprises detecting in the test sample a polypeptide that is encoded by the CSC-associated gene. In certain embodiments, detecting comprises nucleic acid hybridization or nucleic acid amplification. In specific embodiments, the nucleic acid amplification is real-time RT-PCR or RT-PCR. In one embodiment, the nucleic acid hybridization is performed using a nucleic acid array. In certain other embodiments, detecting comprises immunodetection of the polypeptide. In one embodiment, the immunodetection comprises an Enzyme-Linked Immunosorbent Assay (ELISA). In one embodiment, the immunodetection comprises an antibody array. In one embodiment, the immunodetection comprises immunohistochemistry.

In some embodiments of the methods, the reference value is the expression level of the CSC-associated gene in a non-cancer reference sample, and if the expression level of the CSC-associated gene in the test sample is about equal to the expression level of the CSC-associated gene in the non-cancer reference sample, then the comparison does not indicate cancer.

In some embodiments of the methods, the reference value is the expression level of the CSC-associated gene in a cancer reference sample, and if the expression level of the CSC-associated gene is about equal to the expression level of the CSC-associated gene in the cancer reference sample, then the comparison indicates cancer.

In some embodiments of the methods, the CSC-associated gene is in Table 1 or 8 and the reference value is the expression level of the CSC-associated gene in a non-cancer reference sample, and if the expression level of the CSC-associated gene in the test sample is significantly higher than the expression level of the CSC-associated gene in the non-cancer reference sample, the comparison indicates cancer.

In some embodiments of the methods, the CSC-associated gene is in Table 1 or 8 and the reference value is the expression level of the CSC-associated gene in a cancer reference sample, and if the expression level of the CSC-associated gene in the test sample is significantly lower than the expression level of the CSC-associated gene in the cancer reference sample, the comparison does not indicate cancer.

In some embodiments of the methods, the CSC-associated gene is in Table 1 or 8 and the reference value is the expression level of the CSC-associated gene in a non-cancer reference sample, and if the expression level of the CSC-associated gene in the test sample is at least 10% higher than the expression level of the CSC-associated gene in the non-cancer reference sample, the comparison indicates cancer.

In some embodiments of the methods, the CSC-associated gene is in Table 2 or 7 and the reference value is the expression level of the CSC-associated gene in a non-cancer reference sample, and if the expression level of the CSC-associated gene in the test sample is significantly lower than the expression level of the CSC-associated gene in the non-cancer reference sample, the comparison indicates cancer.

In some embodiments of the methods, the CSC-associated gene is in Table 2 or 7 and the reference value is the expression level of the CSC-associated gene in a cancer reference sample, and if the expression level of the CSC-associated gene in the test sample is significantly higher than the expression level of the CSC-associated gene in the cancer reference sample, the comparison does not indicate cancer.

In some embodiments of the methods, the CSC-associated gene is in Table 2 or 7 and the reference value is the expression level of the CSC-associated gene in a non-cancer reference sample, and if the expression level of the CSC-associated gene in the test sample is at least 10% lower than the expression level of the CSC-associated gene in the non-cancer reference sample, the comparison indicates cancer.

The invention, in some aspects, provides methods for isolating a cancer stem cell. In some aspects, the methods involve contacting a sample with an agent that binds a polypeptide, which is encoded by a CSC-associated gene in Table 4 and expressed on the surface of the cancer stem cell, and isolating the agent from the sample. If the sample contains the cancer stem cell, the agent binds to the polypeptide on the surface of the cancer stem cell such that isolation of the agent from the sample results in isolation of the cancer stem cell. In some embodiments, the CSC-associated gene is selected from the group consisting of: ANK2, NCKAP1L, PTPRE, PTPRS, SBF1, SCN3A, SGCA, SGCB, SLC2A11, SLC2A8, SLC4A1, STX3, and TBC1D8. In some embodiments, the agent is an isolated peptide that specifically binds the polypeptide on the surface of the cancer stem cell. In certain embodiments, the isolated peptide is an antibody or antigen-binding fragment. In specific embodiments, the antibody or antigen-binding fragment is a monoclonal antibody, polyclonal antibody, human antibody, chimeric antibody, humanized antibody, single-chain antibody, F(ab′)₂, Fab, Fd, Fv, or single-chain Fv fragment. In some embodiments, the isolated peptide is bound to a solid support. In some embodiments, the isolated peptide is conjugated to a detectable label. In some embodiments, the detectable label is a fluorophore which may be selected from: FITC, TRITC, Cy3, Cy5, Alexa Fluorescent Dyes, and Quantum Dots. In some embodiments, the isolating comprises performing fluorescent activated cell sorting to isolate a cancer stem cell bound to a detectable label. In some embodiments, the cancer stem cell is from a melanoma, breast cancer, prostate cancer, colon cancer or renal cancer.

The invention, in some aspects, provides methods for treating an individual having, or at risk of having, cancer. In some aspects, the methods involve administering a therapeutically effective amount of a composition that induces the expression of a CSC-associated gene selected from the group set forth in Table 2 or 7. In some embodiments, the cancer is melanoma, breast cancer, prostate cancer, colon cancer or renal cancer.

In some embodiments, the composition that induces the expression of a CSC-associated gene comprises an isolated plasmid that expresses the CSC-associated gene. In some embodiments, the isolated plasmid is in a virus capable of infecting the individual. In certain embodiments, the virus is selected from adenovirus, retrovirus, lentivirus, and adeno-associated virus. In some embodiments, the isolated plasmid comprises a cancer specific promoter operably linked to the CSC-associated gene.

The invention, in other aspects, provides methods for treating an individual having, or at risk of having, cancer that involve administering a therapeutically effective amount of a composition that targets a product of a CSC-associated gene selected from the group set forth in Table 1 or 8. In some embodiments, the cancer is melanoma, breast cancer, prostate cancer, colon cancer or renal cancer. In some embodiments, the CSC-associated gene is selected from the group set forth in Table 4. In certain embodiments, the CSC-associated gene is selected from the group consisting of: ANK2, NCKAP1L, PTPRE, PTPRS, SBF1, SCN3A, SGCA, SGCB, SLC2A11, SLC2A8, SLC4A1, STX3, and TBC1D8.

In some embodiments, the composition that targets a product of a CSC-associated gene comprises a small interfering nucleic acid that inhibits expression of the CSC-associated gene. In some embodiments, the composition comprises an isolated plasmid that expresses the small interfering nucleic acid. In certain embodiments, the plasmid is in a virus. In specific embodiments, the virus is selected from adenovirus, retrovirus, lentivirus, and adeno-associated virus. In certain embodiments, the isolated plasmid comprises a cancer-specific promoter operably linked to a gene encoding the small interfering nucleic acid.

In some embodiments, the composition that targets a product (e.g., protein or RNA) of a CSC-associated gene comprises an isolated molecule that selectively binds to a polypeptide encoded by the CSC-associated gene. In certain embodiments, the isolated molecule is conjugated to a therapeutic agent. In specific embodiments, the isolated molecule is an antibody or antigen-binding fragment. In particular embodiments, the antibody or antigen-binding fragment is a monoclonal antibody, polyclonal antibody, human antibody, chimeric antibody, humanized antibody, a single-chain antibody, F(ab′)₂, Fab, Fd, Fv, or single-chain Fv fragment. In specific embodiments, the therapeutic agent is selected from: a toxin, a small-interfering nucleic acid, and a chemotherapeutic agent. In one embodiment, the toxin is a radioisotope. In particular embodiments, the radioisotope is selected from the group consisting of: ²²⁵Ac, ²¹¹At, ²¹²Bi, ²¹³Bi, ¹⁸⁶Rh, ¹⁸⁸Rh, ¹⁷⁷Lu, ⁹⁰Y, ¹³¹I, ⁶⁷Cu, ¹²⁵I, ¹²³I, ⁷⁷Br, ¹⁵³Sm, ¹⁶⁶Bo, ⁶⁴Cu, ²¹²Pb, ²²⁴Ra and ²²³Ra. In some embodiments, the therapeutic agent is a small interfering nucleic acid that inhibits expression of a CSC-associated gene. In some embodiments, the isolated molecule binds to the polypeptide and enters an intracellular compartment of a cancer stem cell of the cancer.

In some embodiments, the treatment methods involve determining the expression level of the CSC-associated gene in the individual. In certain embodiments, the methods involve comparing the expression level of the CSC-associated gene to a reference value, wherein results of the comparison are diagnostic of cancer in the individual. In specific embodiments, if the comparison results in a diagnosis of cancer in the individual, the administering is performed. In one embodiment, the determining and the comparing are repeated at one or more intervals after the administering. In some embodiments, the administering is orally, intravenously, intrapleurally, intranasally, intramuscularly, subcutaneously, intraperitoneally, or as an aerosol.

The invention, in some aspects, provides methods of delivering a therapeutic agent to a cancer stem cell that involve contacting a cancer stem cell with an isolated molecule, which selectively binds to a polypeptide encoded by a CSC-associated gene selected from the group set forth in Table 4 and which is conjugated to a therapeutic agent, in an effective amount to deliver the therapeutic agent to the cancer stem cell. In some embodiments, the CSC-associated gene is selected from the group consisting of: ANK2, NCKAP1L, PTPRE, PTPRS, SBF1, SCN3A, SGCA, SGCB, SLC2A11, SLC2A8, SLC4A1, STX3, and TBC1D8. In some embodiments, the isolated molecule is an antibody or antigen-binding fragment that selectively binds the polypeptide. In some embodiments, the therapeutic agent is selected from: a toxin, a small-interfering nucleic acid, and a chemotherapeutic agent. In one embodiment, the toxin is a radioisotope. In particular embodiments, the radioisotope is selected from the group consisting of: ²²⁵Ac, ²¹¹At, ²¹²Bi, ²¹³Bi, ¹⁸⁶Rh, ¹⁸⁸Rh, ¹⁷⁷Lu, ⁹⁰Y, ¹³¹I, ⁶⁷Cu, ¹²⁵I, ¹²³I, ⁷⁷Br, ¹⁵³Sm, ¹⁶⁶Bo, ⁶⁴Cu, ²¹²Pb, ²²⁴Ra and ²²³Ra. In some embodiments, the therapeutic agent is a small interfering nucleic acid that inhibits expression of a CSC-associated gene. In some embodiments, the cancer stem cell is in vitro. In other embodiments, the cancer stem cell is in vivo.

In some aspects, the invention provides nucleic acid arrays consisting essentially of at least 2, at least 5, at least 10, at least 20, at least 50, at least 100, at least 200, at least 300, or more CSC-associated genes set forth in Table 5.

In some aspects, the invention provides polypeptide arrays consisting essentially of at least 2, at least 5, at least 10, at least 20, at least 50, at least 100, or more polypeptides or immunogenic fragments thereof encoded by CSC-associated genes set forth in Table 1 or 8. In some aspects, the invention provides antibody arrays consisting essentially of at least 2 or more different antibodies or antigen-binding fragments that selectively bind polypeptides encoded by CSC-associated genes set forth in Table 1 or 8.

In some aspects, the invention provides methods for stratifying a population comprising individuals having cancer. The methods involve determining expression levels of at least 2, at least 5, at least 10, at least 20, at least 50, at least 100, at least 200, at least 300, or more CSC-associated genes set forth in Table 5 and stratifying the population based on the expression levels.

In some aspects, the invention provides an isolated molecule that selectively binds to a polypeptide encoded by a CSC-associated gene set forth in Table 4, and that is conjugated to a therapeutic agent. In some embodiments, the CSC-associated gene is selected from the group consisting of: ANK2, NCKAP1L, PTPRE, PTPRS, SBF1, SCN3A, SGCA, SGCB, SLC2A11, SLC2A8, SLC4A1, STX3, and TBC1D8. In some embodiments, the therapeutic agent is selected from: a toxin, a small-interfering nucleic acid, and a chemotherapeutic agent.

In certain embodiments, the isolated molecule is an antibody or antigen-binding fragment. In certain embodiments, the antibody or antigen-binding fragment is a monoclonal antibody, polyclonal antibody, human antibody, chimeric antibody, humanized antibody, single-chain antibody, a F(ab′)₂, Fab, Fd, or Fv fragment. In certain embodiments, the isolated molecule is an isolated receptor ligand of the polypeptide.

The invention, in some aspects, provides compositions comprising any of the foregoing isolated molecules. In some embodiments, the compositions include a pharmaceutically acceptable carrier.

The invention, in some aspects, provides pharmaceutical kits that include a container housing any of the foregoing compositions and instructions for administering the composition to an individual having cancer.

Use of a composition of the invention for treating cancer is also provided as an aspect of the invention.

A method for manufacturing a medicament of a composition of the invention for treating cancer is also provided.

Each of the limitations of the invention can encompass various embodiments of the invention. It is, therefore, anticipated that each of the limitations of the invention involving any one element or combinations of elements can be included in each aspect of the invention. This invention is not limited in its application to the details of construction and the arrangement of components set forth in the following description or illustrated in the drawings. The invention is capable of other embodiments and of being practiced or of being carried out in various ways. Also, the phraseology and terminology used herein is for the purpose of description and should not be regarded as limiting. The use of “including,” “comprising,” or “having,” “containing,” “involving,” and variations thereof herein, is meant to encompass the items listed thereafter and equivalents thereof as well as additional items.

BRIEF DESCRIPTION OF DRAWINGS

FIGS. 1A-1I depict an analysis of vasculogenic/angiogenic pathways in human melanoma. FIG. 1a . is a graphical representation of pathway activation across ABCB5⁺ MMIC. Genes represented by nodes (dark gray circles, TRIO, MET, FLT1, PSEN1, NRP2, RHOA, PTK2, PIP5K3, KIAA1267, MLL, GABPA, ETS1, and CHD8) are overexpressed in ABCB5⁺ relative to ABCB5⁻ human melanoma cells and those represented by black nodes are expressed at lower levels, respectively. Black lines between genes show known interactions. Known gene functions in vasculogenesis and angiogenesis, and genes known as relevant drug targets are annotated (dark gray lines). Gene relationships and figure layout are based on Ingenuity Pathway Analysis and references are provided elsewhere in the text. FIG. 1b . shows detection of vasculogenic/angiogenic pathway members by RT-PCR in ABCB5⁺ MMIC. FIG. 1c . shows FLT1 (VEGFR-1) protein expression on ABCB5⁺ MMIC (top) and ABCB5⁻ melanoma cells (bottom) as determined by dual color flow cytometry using ABCB5 phenotype-specific cell gating, with mean percentages (mean±s.e.m., n=6 replicate experiments) shown on the right. FIG. 1d . depicts representative immunofluorescence staining for CD144 expression (Texas red staining) by ABCB5⁺ MMIC or ABCB5⁻ melanoma cell subpopulations prior to (t=0 h) and upon 48 h of culture (t=48 h) in the presence of 100 ng/ml VEGF¹¹, with nuclei counterstained with DAPI. Mean percentages (mean±s.e.m., n=3 replicate experiments) of cells staining positively for CD144 in each sample are shown on the right. FIG. 1e . shows representative immunofluorescence staining for CD144 expression (Texas red staining) by melanoma cells cultured for 48 h (t=48 h) in the presence of 100 ng/ml VEGF as in above, but in the presence or absence of anti-FLT1 (VEGFR-1) blocking mAb or isotype control mAb. Nuclei are counterstained with DAPI. Mean percentages (mean±s.e.m., n=3 replicate experiments) of cells staining positively for CD144 in each sample are shown in the far right panel. FIG. 1f . shows tube formation detected by phase contrast light microscopy of melanoma cells cultured for 24 h (t=24 h) in the presence of 100 ng/ml VEGF and the presence or absence of anti-FLT1 (VEGFR-1) blocking mAb or isotype control mAb. Number of tubes/microscopy field (mean±s.e.m., n=3 replicate experiments) and tube length (μm) (mean±s.e.m., n=3 replicate experiments) are illustrated for the different experimental conditions on the far right panels, respectively. FIG. 1g . shows the adipogenic differentiation potential of ABCB5⁺ and ABCB5⁻ human melanoma cells (Oil Red O staining, nuclei are counterstained with hematoxylin). FIG. 1h . shows the osteogenic differentiation potential of ABCB5⁺ and ABCB5⁻ human melanoma cells (Alizarin Red staining). FIG. 1i shows the myogenic differentiation potential of ABCB5⁺ and ABCB5⁻ human melanoma cells. Absence of myogenin staining (FITC, green) is detected in ABCB5⁺ or ABCB5⁻ human melanoma cells (nuclei are counterstained with DAPI).

FIGS. 2A-2K depict an analysis of MMIC-driven in vivo vasculogenesis. FIG. 2a . shows conventionally-stained (H&E) sections of human melanoma growing at melanoma cell injection site within human dermis of skin xenograft to NOD/SCID mouse. FIG. 2b . shows immunohistochemistry for human CD31 indicating angiogenic response at perimeter of melanoma within human xenograft; broken line represents interface of tumour nodule with dermal connective tissue. FIG. 2c . shows PAS (with diastase) immunochemical staining of CD31-negative interior regions of melanoma xenograft revealing numerous anastomosing channels (inset is laminin immunohistochemistry indicating identical pattern). FIG. 2d . shows transmission electron micrographs of interior regions of melanoma xenograft; lumenal spaces containing blood products (erythrocytes) are lined by melanoma cells and associated basement membrane-like extracellular matrix. FIG. 2e . shows the interior zone of melanoma xenograft derived from cells expressing GFP transgene and immunohistochemically stained for endothelial marker CD144 (FAST RED Chromogen (SIGNET) from Covance Research Products, Inc); CD144 expression is confined to cells forming lumen-like spaces lined by cells that co-express GFP and CD144 (indicated by dual staining). FIGS. 2f and g . show low (f) and high (g) magnifications of immunohistochemistry for ABCB5 protein; reactivity is restricted to anastomosing channels identical to those seen in panel c. The inset in panel f depicts similar formation of ABCB5-reactive channels in a patient-derived melanoma biopsy. FIG. 2h . depicts in situ hybridization for ABCB5 mRNA revealing a channel pattern corresponding to that of ABCB5 protein expression (compare with panel f; inset is sense control). FIG. 2i . shows the detection of anti-ABCB5 mAb using anti-mouse Ig immunohistochemistry in melanoma xenografts after intravenous administration in vivo; note localization to channels (inset represents anti-mouse Ig staining after intravenous administration of irrelevant isotype-matched control mAb). FIG. 2j . shows dual-labeling immunofluorescence microscopy for ABCB5 (left panel), CD144 (middle panel), and ABCB5 & CD144 (right panel). FIG. 2k shows dual-labeling immunofluorescence microscopy for ABCB5 (left panel), TIE-1 (middle panel), and ABCB5 & TIE-1 (right panel).

FIGS. 3A-3F depict the interdependency of MMIC-driven vasculogenesis and tumourigenesis. FIG. 3a . shows representative flow cytometric ABCB5 expression or control staining (FITC, F11) plotted against forward scatter (FSC) for human A375, MUM-2B, and MUM-2C melanoma cell inocula. FIG. 3b . shows representative histologic sections of melanomas that developed from three unsegregated and ABCB5-depleted melanoma cell lines injected intradermally into human skin xenografts. FIG. 3c . shows histologically determined tumour formation rate (%) 3 weeks following intradermal transplantation of unsegregated vs. ABCB5⁺-depleted human A375, MUM-2B or MUM-2C melanoma cells (2×10⁶/inoculum) into human skin/Rag2^(−/−) chimeric mice (n=5, respectively). FIG. 2d . shows histological tumour volumes (mean±s.e.m.) 3 weeks following intradermal transplantation of unsegregated vs. ABCB5⁺-depleted human A375, MUM-2B or MUM-2C melanoma cells (2×10⁶/inoculum) into human skin/Rag2^(−/−) chimeric mice. FIG. 3e shows immunohistochemistry for laminin revealing extent of channel formation in melanomas that developed from unsegregated or ABCB5⁺-depleted melanoma cell inocula derived from A375, MUM-2B or MUM-2C lines injected intradermally into human skin xenografts (arrows=necrosis). FIG. 3f depicts image analysis of laminin immunoreactivity for melanomas derived from unsegregated and ABCB5⁺-depleted cell inocula; y-axis is percent of pixelated area with reactivity (mean±s.e.m.); solid bar represents tumours derived from unsegregated melanoma cells, open bars represent tumours derived from ABCB5⁺-depleted cells (A375, P<0.0032; MUM-2B, P<0.0005; MUM-2C, P<0.0059).

FIGS. 4A and 4B depict an analysis of the correlation of ABCB5 protein and mRNA expression across human melanoma cell lines. FIG. 4a . shows western blots of ABCB5 and tubulin expression of a panel of human melanoma cell lines. FIG. 4b shows relative ABCB5 mRNA expression (log 2) in a panel of human melanoma cell lines plotted against ABCB5 protein expression as determined by ratios of ABCB5 89 kD western blot band intensity and tubulin western blot band intensity for each human melanoma cell line. Data points in FIG. 4b are: 1, SK-MEL-2; 2, SK-MEL-5; 3, SK-MEL-28; 4, MDA-MB-435; 5, UACC-62; 6, UACC-257; 7, M14; 8, MALME-3M. r, Spearman Rank Correlation r (corrected for ties).

DETAILED DESCRIPTION

The present invention relates in part to the discovery that numerous CSC-associated genes have altered expression or function in cancer stem cells, e.g., melanoma stem cells. In some aspects, the invention relates to diagnostic arrays and methods for detecting cancer, e.g., melanoma, in an individual based on the expression of CSC-associated genes. In other aspects, the invention relates to compositions, kits, and methods useful for treating individuals having cancer. In some embodiments, the treatment methods involve modulating e.g., inducing or inhibiting, the activity of CSC-associated genes. The CSC-associated genes can be modulated by any one of a number of ways known in the art and described herein e.g., overexpression, RNAi-based inhibition, etc. In some cases, the CSC-associated genes encode cell surface proteins which, when upregulated in cancer stem cells, may be selectively targeted for isolating, e.g., by flow cytometry, identifying, e.g., by immunolabeling, and killing of cancer stem cells, e.g., melanoma stem cells.

The mechanism by which CSCs cause tumor formation and growth and the potential role of CSC-specific differentiation plasticity in tumorigenicity are currently unknown. It has been demonstrated according to the invention that CSC play an important role in providing nutritional support to growing tumors. For instance we have shown herein (Examples) a selective capacity of ABCB5⁺ malignant melanoma initiating cells (MMIC)³ to undergo vasculogenic differentiation and to generate blood-perfused vessel-like channels in vivo. A repertoire of genes differentially expressed in MMIC compared to tumour bulk populations were identified by microarray analyses on purified ABCB5⁺ and ABCB5⁻ cell subsets derived from the established human melanoma cell lines and from three separate patient-derived melanoma specimens. Using this approach, 399 genes were identified that were differentially expressed between ABCB5±MMIC and ABCB5⁻ melanoma bulk populations. The genes, which are outlined in Tables 1-8, are referred to herein as CSC-associated genes. Of the CSC-associated genes, 265 were upregulated (Table 1; Table 1 includes Table 1.1 and Table 1.2) and 150 were downregulated (Table 2). For certain CSC-associated genes, subcellular location, e.g., plasma membrane, nucleus, etc., gene type, e.g., enzyme, complex, transporter, etc., and drugs that affect, e.g., target, their activity are identified (Table 3). A summary of those annotations and networks is provide in Table 3. Genes that function share a common pathway have a common “network”) designation in Table 3. Some CSC-associated genes, e.g., those which have “plasma membrane” annotations, encode proteins that are associated with the cell surface. Such cell surface proteins are useful in a variety ways. For example, cell surface proteins that are upregulated in cancer stem cells, may be selectively targeted, e.g., using the methods disclosed herein, for isolating, identifying, and killing of cancer stem cells. A listing of exemplary cell surface proteins encoded by CSC-associated genes is provided in Table 4.

TABLE 1.1 Upregulated CSC-associated genes (p < 0.05) GENESYMBOL ID Fold Change HECW1 237295_at 11.843 RP11-139H14.4 1569124_at 11.472 CDC16 242359_at 6.261 ANK2 202921_s_at 4.162 LOC146325 1553826_a_at 3.943 UGT1A6 206094_x_at 3.86 C12ORF51 1557529_at 3.632 SNRPA1 242146_at 3.54 PDE4B 215671_at 3.457 PAPD4 222282_at 3.39 ZNF536 233890_at 3.303 KSR2 230551_at 3.211 BUB1 233445_at 3.209 ZNF292 236435_at 3.201 CABIN1 1557581_x_at 3.052 SDAD1 242190_at 3.009 ASCC3L1 214982_at 3.009 ZNF224 216983_s_at 2.986 KIDINS220 1557246_at 2.97 WIPF2 216006_at 2.916 C12ORF51 230216_at 2.874 VPS37B 236889_at 2.85 NARG1 1556381_at 2.827 LOC145757 1558649_at 2.779 SDCCAG8 243963_at 2.67 ZNF154 242170_at 2.667 ZFR 238970_at 2.655 TRPV1 1556229_at 2.636 ANAPC5 235926_at 2.631 CUL4A 232466_at 2.607 TRIO 240773_at 2.607 LOC283888 1559443_s_at 2.56 RAB11FIP3 228613_at 2.546 PTK2 234211_at 2.539 MYO10 243159_x_at 2.528 NAT8B 206964_at 2.513 CDC14B 234605_at 2.512 TRIM33 239716_at 2.496 SF1 210172_at 2.452 SGCA 1562729_at 2.395 LOC285147 236166_at 2.377 N4BP2L2 242576_x_at 2.349 HNRPH1 213472_at 2.332 FLJ10357 241627_x_at 2.31 PHF20L1 219606_at 2.3 ANKRD28 241063_at 2.297 TRNT1 243236_at 2.295 GOLGA8A 213650_at 2.289 KIAA1618 231956_at 2.27 RBM5 209936_at 2.249 LOC645513 239556_at 2.24 LOC729397 236899_at 2.231 PABPN1 213046_at 2.228 SVIL 215279_at 2.228 PIP5K3 1557719_at 2.227 STRAP 1558002_at 2.189 KIAA2013 1555933_at 2.18 NUPL1 241425_at 2.179 IFNGR1 242903_at 2.171 AKAP9 215483_at 2.168 LOC254128 1557059_at 2.164 IRS2 236338_at 2.162 RHOA 240337_at 2.143 JARID2 232835_at 2.139 GPD2 243598_at 2.13 RADIL 223693_s_at 2.126 CROP 242389_at 2.121 EXT1 242126_at 2.116 XRCC5 232633_at 2.106 PDXDC1 1560014_s_at 2.105 MEF2C 236395_at 2.104 ZNF567 242429_at 2.103 ZNF337 1565614_at 2.096 TTLL4 1557611_at 2.092 FUBP1 240307_at 2.087 NPTN 228723_at 2.086 TPM4 235094_at 2.079 NCKAP1L 209734_at 2.071 KRTAP19-1 1556410_a_at 2.07 SLC30A9 237051_at 2.063 HDAC3 240482_at 2.062 C10ORF18 244165_at 2.046 SMA4 238446_at 2.035 GBF1 233114_at 2.03 GABPA 243498_at 2.03 SFRS15 243759_at 2.028 CREB3L2 237952_at 2.013 SLC2A8 239426_at 2.012 N4BP2L1 213375_s_at 2.01 IDS 1559136_s_at 2.001 COBRA1 1556434_at 1.985 TXNL1 243664_at 1.98 LOC388135 230475_at 1.979 MTUS1 239576_at 1.975 TAF15 227891_s_at 1.971 HNRPD 241702_at 1.962 TRIM46 238147_at 1.96 NBR1 1568856_at 1.957 WDR68 233782_at 1.924 HNRPD 235999_at 1.92 BLID 239672_at 1.91 LOC145786 229178_at 1.907 HOXD3 206601_s_at 1.897 AOC3 204894_s_at 1.894 PRPF38B 230270_at 1.888 SLC20A1 230494_at 1.884 SEC16B 1552880_at 1.877 FLT1 232809_s_at 1.861 HUWE1 214673_s_at 1.858 BUB1 216277_at 1.856 GPR135 241085_at 1.851 PSEN1 242875_at 1.851 KIAA0907 230028_at 1.83 POLR2J2 1552622_s_at 1.828 SFRS15 222311_s_at 1.818 CBS 240517_at 1.818 ETS1 241435_at 1.797 LRRFIP1 239379_at 1.796 OCIAD1 235537_at 1.794 LRCH3 229387_at 1.793 CCDC14 240884_at 1.771 HNRNPC 235500_at 1.769 DCUN1D2 240478_at 1.76 NPAS2 1557690_x_at 1.76 POFUT2 207448_at 1.759 CHD2 244443_at 1.757 TMEM165 1560622_at 1.756 FLJ31306 239432_at 1.753 HPS1 239382_at 1.749 WTAP 1560274_at 1.747 TNPO1 1556116_s_at 1.739 ZFHX3 215828_at 1.737 AKR1CL2 1559982_s_at 1.732 C20ORF4 234654_at 1.731 CCDC57 214818_at 1.703 MALAT1 224568_x_at 1.699 EWSR1 229966_at 1.686 MYO10 244350_at 1.677 MALAT1 223940_x_at 1.659 ATXN2L 207798_s_at 1.656 PDK1 239798_at 1.654 POLR2J2 1552621_at 1.652 CENPJ 220885_s_at 1.64 PDSS1 236298_at 1.64 UNK 1562434_at 1.637 BDP1 224227_s_at 1.632 N4BP2L2 235547_at 1.631 MDM4 235589_s_at 1.629 SNORA28 241843_at 1.628 ZFX 207920_x_at 1.625 NAPA 239362_at 1.624 PRO1073 228582_x_at 1.607 MLL 212079_s_at 1.599 SGOL2 235425_at 1.591 RBM25 1557081_at 1.57 BARD1 205345_at 1.559 LOC388969 232145_at 1.555 GGT1 211417_x_at 1.555 FAM62C 239770_at 1.551 TTC9C 1569189_at 1.55 TCAG7.907 238678_at 1.546 OSGEP 242930_at 1.541 RHOBTB2 1556645_s_at 1.538 C5ORF24 229098_s_at 1.531 RBM4 213718_at 1.53 SLC2A11 232167_at 1.529 DDX17 213998_s_at 1.528 C22ORF30 216555_at 1.521 C9ORF85 244160_at 1.52 DNM1L 236032_at 1.503 SQLE 213577_at 1.502 CRIPAK 228318_s_at 1.486 ZNF800 227101_at 1.484 RAD54L 204558_at 1.483 TAF1B 239046_at 1.468 THRAP3 217847_s_at 1.464 CNIH3 232758_s_at 1.451 UQCC 229672_at 1.451 HOXA2 228642_at 1.44 RBM26 229433_at 1.43 RFT1 240281_at 1.426 MTERFD3 225341_at 1.422 LOC641298 208118_x_at 1.419 ZNF326 241720_at 1.418 NBPF16 201104_x_at 1.411 ASPM 232238_at 1.411 RNF43 228826_at 1.401 IPW 213447_at 1.399 TTC3 208664_s_at 1.396 USP36 224979_s_at 1.393 KIAA0841 36888_at 1.389 NEK1 213328_at 1.381 AMZ2 227567_at 1.377 TBC1D8 204526_s_at 1.373 STK36 231806_s_at 1.362 SF3B1 214305_s_at 1.359 HELLS 242890_at 1.359 SYNE2 202761_s_at 1.356 KIAA1267 224489_at 1.355 C14ORF135 1563259_at 1.353 SF3B1 201070_x_at 1.35 CLN8 229958_at 1.344 STK36 234005_x_at 1.335 ZNF226 219603_s_at 1.332 COQ4 218328_at 1.328 DTX3 49051_g_at 1.32 WFS1 1555270_a_at 1.315 ZNF251 226754_at 1.313 ARS2 201679_at 1.307 ATAD2 235266_at 1.304 CCDC73 239848_at 1.294 BCL9L 227616_at 1.291 MET 213816_s_at 1.283 NFATC2IP 217527_s_at 1.272 CHD8 212571_at 1.27 TNRC6A 234734_s_at 1.268 OSBPL5 233734_s_at 1.261 COIL 203653_s_at 1.259 CPEB2 226939_at 1.251 TBC1D8 221592_at 1.246 RUNX3 204198_s_at 1.233 LBA1 213261_at 1.225 CENPJ 234023_s_at 1.22 MARCH6 201737_s_at 1.219 ANKRD44 226641_at 1.218 NAPE-PLD 242635_s_at 1.216 C12ORF48 220060_s_at 1.216 CCDC93 219774_at 1.208 ZUFSP 228330_at 1.205 SMC6 218781_at 1.203 TAOK3 220761_s_at 1.195 JARID1A 226367_at 1.192 DCLRE1C 242927_at 1.187 TTC26 233999_s_at 1.184 EIF4G3 201935_s_at 1.174 ORMDL1 223187_s_at 1.171 TCOF1 202385_s_at 1.169 CCDC52 234995_at 1.166 PMS2L3 214473_x_at 1.159 HERC5 219863_at 1.156 CASC5 228323_at 1.144 SON 201085_s_at 1.144 APBB2 40148_at 1.139 LOC338799 226369_at 1.137 PHC1 218338_at 1.123 DEPDC1 232278_s_at 1.119 NRP2 210841_s_at 1.106 ZMYND8 209049_s_at 1.102 CEP55 218542_at 1.096

TABLE 1.2 Highly upregulated genes as detected by RT-PCR ABCB5+/ ABCB5− Description Gname Fold change Angiopoietin-like 3 ANGPT5 3.0596 Brain-specific angiogenesis inhibitor FLJ41988 3.0596 1 Cadherin 5, type 2, VE-cadherin 7B4/CD144 3.0596 (vascular epithelium) Epidermal growth factor (beta- HOMG4/URG 187.8365 urogastrone) C-fos induced growth factor VEGF-D/VEGFD 3.5884 (vascular endothelial growth factor D) Hepatocyte growth factor F-TCF/HGFB 4.542 (hepapoietin A; scatter factor) Heparanase HPA/HPR1 286.6871 Insulin-like growth factor 1 IGFI 4.7022 (somatomedin C) Jagged 1 (Alagille syndrome) AGS/AHD 1566.5046 Laminin, alpha 5 KIAA1907 3.8727 Platelet/endothelial cell adhesion CD31/PECAM-1 11.9037 molecule (CD31 antigen) Plexin domain containing 1 DKFZp686F0937/ 3.4184 TEM3 Stabilin 1 CLEVER-1/FEEL-1 4.357 Transforming growth factor, alpha TFGA 3549.3357 Tumor necrosis factor (TNF DIF/TNF-alpha 4.0652 superfamily, member 2) Vascular endothelial growth factor C Flt4-L/VRP 446.7529

TABLE 2 Downregulated CSC-associated genes (p < 0.05) GENESYMBOL ID Fold Change ECHDC1 233124_s_at 0.943 DARS 201624_at 0.928 GALNT1 201722_s_at 0.926 CGGBP1 224600_at 0.913 CSE1L 201112_s_at 0.911 GMFB 202544_at 0.904 RPL7L1 225515_s_at 0.899 SKP1 200718_s_at 0.898 IGHMBP2 215980_s_at 0.893 LOC137886 212934_at 0.886 CSE1L 210766_s_at 0.885 ERRFI1 224657_at 0.881 MAP2K4 203266_s_at 0.881 TNFAIP1 201207_at 0.88 TBXA2R 207554_x_at 0.877 SEPHS1 208940_at 0.875 IPO7 200993_at 0.875 C16ORF63 225087_at 0.872 INSIG2 209566_at 0.872 TFB1M 228075_x_at 0.87 PAK1 226507_at 0.869 C14ORF156 221434_s_at 0.867 SMYD2 212922_s_at 0.867 ENTPD5 231676_s_at 0.867 PPP3CA 202457_s_at 0.867 MBNL1 201152_s_at 0.867 MRPL42 217919_s_at 0.866 SUPT7L 201838_s_at 0.865 PMP22 210139_s_at 0.865 GABARAPL2 209046_s_at 0.863 PITPNA 201190_s_at 0.863 C2ORF30 224630_at 0.851 TXNDC12 223017_at 0.849 POP4 202868_s_at 0.847 MRPL51 224334_s_at 0.846 AK3 224655_at 0.845 GPR107 211979_at 0.843 TMEM126B 221622_s_at 0.843 PSMA2 201316_at 0.839 KIAA1737 225623_at 0.837 TRAPPC2L 218354_at 0.837 RLBP1L1 224996_at 0.835 CCDC127 226515_at 0.835 CPNE3 202119_s_at 0.833 HIAT1 225222_at 0.832 MECR 218664_at 0.832 ACBD6 225317_at 0.83 SLC16A1 202235_at 0.83 ANXA4 201302_at 0.83 DNAJC21 230893_at 0.829 C22ORF28 200042_at 0.829 SPOPL 225659_at 0.828 PDHB 211023_at 0.827 EIF2S1 201144_s_at 0.824 LOC645166 228158_at 0.823 CAMK2D 225019_at 0.823 LIMS1 212687_at 0.822 VTI1B 209452_s_at 0.821 YY1 224711_at 0.821 TRAPPC2 219351_at 0.821 LOC126917 225615_at 0.819 STX8 204690_at 0.819 NANP 228073_at 0.817 NDFIP1 217800_s_at 0.815 UBE3C 1560739_a_at 0.815 KPNA6 226976_at 0.814 C19ORF42 219097_x_at 0.813 DHX40 218277_s_at 0.812 NUCB2 203675_at 0.812 RAB1A 213440_at 0.81 USP8 229501_s_at 0.808 MAP1LC3B 208785_s_at 0.808 PDHB 208911_s_at 0.807 SH2B3 203320_at 0.806 PPP1R3D 204554_at 0.805 DEGS1 209250_at 0.804 HSDL2 209513_s_at 0.803 LOC203547 225556_at 0.802 CANX 238034_at 0.8 PSMA3 201532_at 0.798 PIGY 224660_at 0.793 CYB5R3 1554574_a_at 0.793 BRI3 223376_s_at 0.792 CREB1 204313_s_at 0.791 LOC389203 225014_at 0.79 WDR41 218055_s_at 0.789 C9ORF78 218116_at 0.789 GNPDA1 202382_s_at 0.787 RPE 225039_at 0.787 HSPA4L 205543_at 0.786 SEPT11 201307_at 0.784 HEATR2 241352_at 0.784 ENAH 222433_at 0.783 MED19 226300_at 0.782 TBC1D5 201814_at 0.782 EMP2 225079_at 0.781 STX11 235670_at 0.778 ANKH 229176_at 0.776 ENDOD1 212573_at 0.775 IL13RA1 201887_at 0.775 RAB14 200927_s_at 0.772 TMEM30A 232591_s_at 0.771 DDX52 212834_at 0.771 PTPMT1 229535_at 0.769 SRPRB 218140_x_at 0.767 FAM98A 212333_at 0.767 SRP72 208803_s_at 0.766 RPE 221770_at 0.766 HOXB9 216417_x_at 0.766 MAEA 207922_s_at 0.765 GHITM 1554510_s_at 0.764 CAPZB 201949_x_at 0.764 ANKRD52 228257_at 0.762 MOBKL1B 214812_s_at 0.762 MIA3 1569057_s_at 0.759 UBE2E3 210024_s_at 0.758 CAMK2D 228555_at 0.758 UBXD7 212840_at 0.754 C18ORF10 213617_s_at 0.754 HSD17B1 228595_at 0.753 PDLIM5 212412_at 0.752 SRP72 208801_at 0.751 ZNF618 226590_at 0.75 TSPAN31 203227_s_at 0.744 MAP3K15 200979_at 0.741 C18ORF10 212055_at 0.737 ATP5I 207335_x_at 0.737 TOX4 201685_s_at 0.73 TBXA2R 336_at 0.73 COL4A2 211966_at 0.729 TIMM23 218119_at 0.723 NDUFAF2 228355_s_at 0.722 FOXN3 218031_s_at 0.721 EIF2S1 201142_at 0.717 NDUFB6 203613_s_at 0.712 TM6SF1 1558102_at 0.704 ELOVL2 213712_at 0.699 PPP1R7 201213_at 0.698 BAT3 230513_at 0.697 ZNF668 219047_s_at 0.691 ERBB3 1563253_s_at 0.691 C12ORF45 226349_at 0.688 PGRMC2 213227_at 0.686 NUDT4 212183_at 0.685 AABHD7 239579_at 0.661 CEP27 228744_at 0.651 RAB11FIP3 216043_x_at 0.551 FHL3 218818_at 0.546 NAALAD2 1554506_x_at 0.464 LOC219731 1557208_at 0.419

TABLE 3 CSC-genes annotations Entrez Gene ID for Fold Name Human Affymetrix Change Networks Location Type Drugs Actin — 1 Unknown group ADA 100 — 8 Cytoplasm enzyme pentostatin, vidarabine Adaptor protein 2 — 8 Unknown complex AFP 174 — 5 Extracellular transporter Space AGT 183 — 8 Extracellular other Space AHR 196 — 7 Nucleus ligand- dependent nuclear receptor AKAP9 10142 215483_at 2.168 1 Cytoplasm other Akt — 2 Unknown group amino acids — 6 Unknown chemical - endogenous mammalian AMPH 273 — 8 Plasma other Membrane AMZ2 51321 227567_at 1.377 8 Unknown other ANAPC1 64682 — 4 Nucleus other ANAPC10 10393 — 4 Nucleus enzyme ANAPC11 51529 — 4 Unknown enzyme ANAPC13 25847 — 4 Unknown other ANAPC2 29882 — 4 Nucleus enzyme ANAPC4 29945 — 4 Unknown enzyme ANAPC5 51433 235926_at 2.631 4 Nucleus enzyme ANAPC7 51434 — 4 Unknown other ANK2 287 202921_s_at 4.162 4 Plasma other Membrane ANKRD28 23243 241063_at 2.297 13 Unknown other AOC3 8639 204894_s_at 1.894 2 Plasma enzyme Membrane AP2A2 161 — 8 Cytoplasm transporter APBB2 323 40148_at 1.139 9 Cytoplasm other APP 351 — 9 Plasma other AAB-001 Membrane ARD1A 8260 — 8 Nucleus enzyme Arf — 8 Unknown group ARF5 381 — 8 Cytoplasm transporter ARHGDIB 397 — 7 Cytoplasm other ASCC3L1 23020 214982_at 3.009 9 Nucleus enzyme (includes EG: 23020) ASCL1 429 — 9 Nucleus transcription regulator ASPM 259266 232238_at 1.411 3 Nucleus other ATAD2 29028 235266_at 1.304 7 Unknown other ATP — 9 Unknown chemical - endogenous mammalian ATXN2L 11273 207798_s_at 1.656 9 Unknown other BARD1 580 205345_at 1.559 1 Nucleus transcription regulator BCL2 596 — 6 Cytoplasm other oblimersen, (−)-gossypol BCL9L 283149 227616_at 1.291 6 Cytoplasm other BDP1 55814 224227_s_at 1.632 9 Nucleus transcription regulator beta-estradiol — 3 Unknown chemical - endogenous mammalian BRF1 2972 — 9 Nucleus transcription regulator BUB1 (includes 699 233445_at 3.209 5 Nucleus kinase EG: 699) BUB1B 701 — 4 Nucleus kinase C12ORF48 55010 220060_s_at 1.216 Unknown other C12ORF51 283450 1557529_at 3.632 4 Unknown other CABIN1 23523 1557581_x_at 3.052 1 Nucleus other Calmodulin — 1 Unknown group CASC5 57082 228323_at 1.144 3 Nucleus other CASP3 836 — 4 Cytoplasm peptidase IDN-6556 CASP6 839 — 9 Cytoplasm peptidase CBS 875 240517_at 1.818 1 Cytoplasm enzyme CD151 977 — 7 Plasma other Membrane CDC14B 8555 234605_at 2.512 5 Nucleus phosphatase CDC16 8881 242359_at 6.261 4 Nucleus other CDC20 991 — 3 Nucleus other CDC23 (includes 8697 — 4 Nucleus enzyme EG: 8697) CDC26 246184 — 4 Nucleus other CDC27 996 — 4 Nucleus other CDC5L 988 222179_at 1.292 9 Nucleus other CDK2 1017 — 7 Nucleus kinase BMS-387032, flavopiridol CDKN1A 1026 — 7 Nucleus kinase CDT1 81620 — 7 Nucleus other CDX1 1044 — 9 Nucleus transcription regulator CENPJ 55835 220885_s_at 1.64 4 Nucleus transcription regulator CEP55 55165 218542_at 1.096 5 Unknown other CHD8 57680 212571_at 1.27 1 Nucleus enzyme CHEK2 11200 — 5 Nucleus kinase CHRM3 1131 — 8 Plasma G-protein fesoterodine, Membrane coupled ABT-089, receptor atropine/edrophonium, cyclopentolate/ phenylephrine, ipratropium/albuterol, trihexyphenidyl, carbamylcholine, darifenacin, methacholine, diphenhydramine, quinidine, procyclidine, trospium, atropine sulfate/benzoic acid/hyoscyamine/ methenamine/methylene blue/phenyl salicylate, homatropine, dicyclomine, methantheline, orphenadrine, fluoxetine/olanzapine, doxacurium, aspirin/caffeine/ orphenadrine, propantheline, tridihexethyl, biperiden, anisotropine methylbromide, glycopyrrolate, diphenhydramine/8- chlorotheophylline, atropine/ hyoscyamine/ phenobarbital/ scopolamine, atropine sulfate/diphenoxylate hydrochloride, pipecuronium, flavoxate, chlorpheniramine/ methscopolamine/ phenylephrine, mepenzolic acid, atropine sulfate/difenoxin hydrochloride, homatropine methylbromide, hydroxyamphetamine/ tropicamide, cisatracurium, hyoscyamine/ phenobarbital, bethanechol, olanzapine, oxybutynin, tropicamide, solifenacin, cyclopentolate, tolterodine, cevimeline, acetylcholine, ipratropium, atropine, pilocarpine, benztropine, hyoscyamine, arecoline, scopolamine, N- methylscopolamine, tiotropium, carbinoxamine, buclizine, diphenhydramine/ phenylephrine, brompheniramine CIB1 10519 — 7 Nucleus other Ck2 — 1 Unknown complex CKM 1158 — 5 Cytoplasm kinase CLIC1 1192 — 9 Nucleus ion channel CLIC4 25932 — 6 Cytoplasm ion channel CLIC5 53405 — 1 Cytoplasm ion channel CLN8 2055 229958_at 1.344 Cytoplasm other COIL 8161 203653_s_at 1.259 6 Nucleus other COL4A1 1282 — 5 Extracellular other collagenase Space COPB1 1315 — 8 Cytoplasm transporter Creb — 2 Unknown group CREB3L2 64764 237952_at 2.013 3 Unknown other CRIPAK 285464 228318_s_at 1.486 Cytoplasm other CROP 51747 242389_at 2.121 7 Nucleus other CRY1 1407 — 7 Nucleus enzyme CTNNA1 1495 — 6 Plasma other Membrane CTNNAL1 8727 — 6 Plasma other Membrane CTNNB1 1499 — 6 Nucleus transcription regulator CUL4A 8451 232466_at 2.607 1 Nucleus other DAPK1 1612 — 6 Cytoplasm kinase DCLRE1C 64421 242927_at 1.187 Nucleus enzyme DDX17 10521 213998_s_at 1.528 6 Nucleus enzyme DENND4A 10260 230607_at 2.368 1 Nucleus other DMD 1756 — 8 Plasma other Membrane DNM1L 10059 236032_at 1.503 2 Cytoplasm enzyme DSN1 79980 — 3 Nucleus other DTX — 3 Unknown group DTX1 1840 — 3 Nucleus transcription regulator DTX2 113878 — 3 Nucleus other DTX3 196403 49051_g_at 1.32 3 Cytoplasm other DUB — 18 Unknown group DVL1 1855 — 6 Cytoplasm other DVL2 1856 — 6 Cytoplasm other Dynamin — 2 Unknown group EGFR 1956 — 7 Plasma kinase cetuximab, AEE Membrane 788, panitumumab, BMS-599626, ARRY-334543, XL647, canertinib, gefitinib, HKI-272, PD 153035, lapatinib, vandetanib, erlotinib EIF4G3 8672 201935_s_at 1.174 4 Cytoplasm translation regulator EPOR 2057 — 9 Plasma transmembrane erythropoietin, Membrane receptor darbepoetin alfa, continuous erythropoietin receptor activator ERBB2 2064 — 3 Plasma kinase trastuzumab, BMS- Membrane 599626, ARRY- 334543, XL647, CP- 724, 714, HKI-272, lapatinib, erlotinib ETS1 2113 241435_at 1.797 2 Nucleus transcription regulator EWSR1 2130 229966_at 1.686 1 Nucleus other EXT1 2131 242126_at 2.116 4 Cytoplasm enzyme FLOT1 10211 — 3 Plasma other Membrane FLT1 2321 232809_s_at 1.861 2 Plasma kinase sunitinib, axitinib, Membrane CEP 7055 FMR1 2332 — 7 Nucleus other FRK 2444 — 9 Nucleus kinase FUBP1 8880 240307_at 2.087 1 Nucleus transcription regulator FZR1 51343 — 4 Nucleus other GABPA 2551 243498_at 2.03 2 Nucleus transcription regulator GBF1 8729 233114_at 2.03 8 Cytoplasm other GGT1 2678 211417_x_at 1.555 6 Cytoplasm enzyme GPD2 2820 243598_at 2.13 3 Cytoplasm enzyme HDAC3 8841 240482_at 2.062 1 Nucleus transcription tributyrin, PXD101, regulator pyroxamide, MGCD0103, vorinostat, FR 901228 HECW1 23072 237295_at 11.843 6 Cytoplasm enzyme HELLS 3070 242890_at 1.359 3 Nucleus enzyme HERC5 51191 219863_at 1.156 6 Cytoplasm enzyme Histone h3 — 1 Unknown group HNRNPC 3183 235500_at 1.769 1 Nucleus other HNRPD 3184 241702_at 1.962 4 Nucleus transcription regulator HNRPH1 3187 213472_at 2.332 8 Nucleus other HOXA2 3199 228642_at 1.44 8 Nucleus transcription regulator HOXD3 3232 206601_s_at 1.897 7 Nucleus transcription regulator HPS1 3257 239382_at 1.749 14 Cytoplasm other HPS4 89781 — 14 Cytoplasm other HSPA5 3309 — 3 Cytoplasm other HUWE1 10075 214673_s_at 1.858 6 Nucleus transcription regulator IFNG 3458 — 9 Extracellular cytokine Space IFNGR1 3459 242903_at 2.171 4 Plasma transmembrane interferon Membrane receptor gamma-1b IL1B 3553 — 4 Extracellular cytokine IL-1 trap Space Insulin — 2 Unknown group IRS2 8660 236338_at 2.162 2 Cytoplasm other ITGB3 3690 — 7 Plasma transmembrane TP 9201, Membrane receptor EMD121974, tirofiban ITPR1 3708 — 4 Cytoplasm ion channel JARID1A 5927 226367_at 1.192 9 Nucleus transcription regulator JARID2 3720 232835_at 2.139 4 Nucleus transcription regulator Jnk — 2 Unknown group KIAA1267 284058 224489_at 1.355 1 Nucleus other KIDINS220 57498 1557246_at 2.97 6 Nucleus transcription regulator KIR2DL3 3804 — 9 Plasma other Membrane KITLG (includes 4254 — 9 Extracellular growth factor EG: 4254) Space KLF6 1316 — 5, 9 Nucleus transcription regulator LCN2 3934 — 9 Extracellular transporter Space LMO2 4005 — 9 Nucleus other LOC388135 388135 230475_at 1.979 5 Unknown other LRRFIP1 9208 239379_at 1.796 3 Nucleus transcription regulator MALAT1 378938 224568_x_at 1.699 Unknown other Mapk — 2 Unknown group MEF2C 4208 236395_at 2.104 2 Nucleus transcription regulator MET 4233 213816_s_at 1.283 2 Plasma kinase Membrane mGluR — 8 Unknown group MIS12 79003 — 3 Nucleus other MLL 4297 212079_s_at 1.599 1 Nucleus transcription regulator MPL 4352 — 9 Plasma transmembrane SB-497115 Membrane receptor MTUS1 57509 239576_at 1.975 1 Unknown other MYC 4609 — 6 Nucleus transcription regulator MYF6 4618 — 5 Nucleus transcription regulator MYO10 4651 243159_x_at 2.528 3 Cytoplasm other MYOD1 4654 — 5 Nucleus transcription regulator N4BP2L1 90634 213375_s_at 2.01 Unknown other Nap125 — 16 Unknown group NAPA 8775 239362_at 1.624 2 Cytoplasm transporter NAPE-PLD 222236 242635_s_at 1.216 8 Cytoplasm enzyme NARG1 80155 1556381_at 2.827 8 Nucleus transcription regulator NAT13 80218 — 8 Cytoplasm enzyme NBPF15 284565 201104_x_at 1.411 1 Unknown other NBR1 4077 1568856_at 1.957 5 Unknown other NCKAP1L 3071 209734_at 2.071 16 Plasma other Membrane NCOA3 8202 — 7 Nucleus transcription regulator NEK1 4750 213328_at 1.381 6 Nucleus kinase NES 10763 — 5 Cytoplasm other NFATC2IP 84901 217527_s_at 1.272 1 Nucleus other NFkB — 2 Unknown complex NFKBIE (includes 4794 — 13 Nucleus transcription EG: 4794) regulator NMB 4828 — 8 Extracellular other Space NPAS2 4862 1557690_x_at 1.76 7 Nucleus transcription regulator NPTN 27020 228723_at 2.086 1 Plasma other Membrane NRP2 8828 210841_s_at 1.106 2, 3 Plasma kinase Membrane NUPL1 9818 241425_at 2.179 17 Nucleus transporter OGG1 4968 — 9 Nucleus enzyme OSBPL5 114879 233734_s_at 1.261 3 Cytoplasm other OSGEP 55644 242930_at 1.541 3 Unknown peptidase P38 MAPK — 2 Unknown group PABPN1 8106 213046_at 2.228 5 Nucleus other PAX3 5077 — 7 Nucleus transcription regulator PCBP1 (includes 5093 — 6 Nucleus translation EG: 5093) regulator PDE4B 5142 215671_at 3.457 2 Cytoplasm enzyme dyphylline, nitroglycerin, arofylline, tetomilast, L 869298, aminophylline, anagrelide, cilomilast, milrinone, rolipram, dipyridamole, L- 826, 141, roflumilast, tolbutamide, theophylline, pentoxifylline, caffeine PDE5A 8654 239556_at 2.24 4 Cytoplasm enzyme dyphylline, nitroglycerin, DA- 8159, aminophylline, sildenafil, dipyridamole, aspirin/dipyridamole, vardenafil, tolbutamide, tadalafil, theophylline, pentoxifylline PDGF BB — 2 Unknown complex PDK1 5163 239798_at 1.654 1 Cytoplasm kinase PDSS1 23590 236298_at 1.64 15 Unknown enzyme PDXDC1 23042 1560014_s_at 2.105 8 Unknown other PHC1 1911 218338_at 1.123 5 Nucleus other PI3K — 2 Unknown complex PIP5K1C 23396 — 7 Plasma kinase Membrane PIP5K3 200576 1557719_at 2.227 2 Cytoplasm kinase Pka — 1 Unknown complex Pkc(s) — 2 Unknown group PLAA 9373 — 4 Cytoplasm other PLC gamma — 2 Unknown group Pld — 8 Unknown group PLK1 5347 — 7 Nucleus kinase BI 2536 PMS2L3 5387 214473_x_at 1.159 3 Unknown other POLR2J2 246721 1552622_s_at 1.828 1 Nucleus transcription regulator POU4F2 5458 — 6 Nucleus transcription regulator PP2A — 6 Unknown complex PRDM5 11107 — 5 Nucleus other PRKCB1 5579 — 7 Cytoplasm kinase enzastaurin, ruboxistaurin progesterone — 8 Unknown chemical - endogenous mammalian PSEN1 5663 242875_at 1.851 2 Plasma peptidase (R)-flurbiprofen Membrane PTEN 5728 — 3 Cytoplasm phosphatase PTK2 5747 234211_at 2.539 2 Cytoplasm kinase PTPN12 5782 — 7 Cytoplasm phosphatase PTPN14 5784 — 6 Cytoplasm phosphatase PTPRA 5786 — 7 Plasma phosphatase Membrane PTPRD 5789 — 6 Plasma phosphatase Membrane PTPRE 5791 — 7 Plasma phosphatase Membrane PTPRS (includes 5802 1556116_s_at 1.739 7 Plasma phosphatase EG: 5802) Membrane RAB11FIP3 9727 228613_at 2.546 8 Cytoplasm other RAB11FIP4 84440 — 8 Cytoplasm other Rac — 2 Unknown group RAD50 10111 — 5 Nucleus enzyme RAD54L 8438 204558_at 1.483 5 Nucleus enzyme RB1 5925 — 9 Nucleus transcription regulator RBM25 58517 1557081_at 1.57 7 Nucleus other RBM4 5936 213718_at 1.53 7 Nucleus other RBM5 10181 209936_at 2.249 6 Nucleus other RDBP 7936 — 3 Nucleus other RHOA 387 240337_at 2.143 2 Cytoplasm enzyme RHOBTB2 23221 1556645_s_at 1.538 Unknown enzyme RNA polymerase II — 1 Unknown complex RNU1A 6060 — 1 Unknown other RP13-122B23.3 25920 1556434_at 1.985 3 Nucleus other RPL10 6134 — 6 Cytoplasm other RUNX3 864 204198_s_at 1.233 7 Nucleus transcription regulator SBF1 6305 — 3 Plasma phosphatase Membrane SCMH1 22955 — 5 Nucleus transcription regulator SCN3A 6328 — 4 Plasma ion channel riluzole Membrane SEC16A 9919 — 10 Cytoplasm phosphatase SEC16B 89866 1552880_at 1.877 10 Nucleus other Secretase gamma — 9 Unknown complex SF1 7536 210172_at 2.452 1, 4 Nucleus transcription regulator SF3B1 23451 214305_s_at 1.359 1 Nucleus other SFRS15 57466 243759_at 2.028 Nucleus other SGCA 6442 1562729_at 2.395 8 Plasma other Membrane SGCB 6443 — 8 Plasma other Membrane SGCD 6444 — 8 Cytoplasm other SGCG 6445 — 8 Plasma other Membrane SH2D1A (includes 4068 — 5 Cytoplasm other EG: 4068) SKIL 6498 — 4 Nucleus transcription regulator SLC29A1 2030 — 9 Plasma transporter Membrane SLC2A11 66035 232167_at 1.529 9 Plasma other Membrane SLC2A8 29988 239426_at 2.012 Plasma transporter Membrane SLC30A9 10463 237051_at 2.063 7 Nucleus transporter SLC4A1 6521 — 9 Plasma transporter Membrane SMAD4 4089 — 6 Nucleus transcription regulator SMARCA5 8467 — 9 Nucleus transcription regulator SMC5 23137 — 12 Nucleus other SMC6 79677 218781_at 1.203 12 Nucleus other SMN1 6606 — 6 Nucleus other SNRPA1 6627 242146_at 3.54 8 Nucleus other SNW1 22938 — 5 Nucleus transcription regulator SON 6651 201085_s_at 1.144 5 Nucleus other SP4 6671 — 3 Nucleus transcription regulator sphingomyelin — 9 Unknown chemical - endogenous mammalian SPN 6693 — 3 Plasma transmembran Membrane e receptor SPTBN1 6711 — 4, 6, 8 Plasma other Membrane SQLE 6713 213577_at 1.502 3 Cytoplasm enzyme SQSTM1 8878 — 5 Cytoplasm transcription regulator SRC 6714 — 6 Cytoplasm kinase dasatinib, AZM-475271 STK36 27148 231806_s_at 1.362 6 Unknown kinase STRAP 11171 1558002_at 2.189 2 Plasma other Membrane STX3 6809 — 7 Plasma transporter Membrane SUMO1 7341 — 8 Nucleus enzyme SUMO2 6613 — 9 Nucleus other SVIL 6840 215279_at 2.228 4 Plasma other Membrane SYNE2 23224 202761_s_at 1.356 1 Nucleus other TAF15 8148 227891_s_at 1.971 1 Nucleus transcription regulator TAF1A 9015 — 5 Nucleus transcription regulator TAF1B 9014 239046_at 1.468 5 Nucleus transcription regulator TAF1C 9013 — 5 Nucleus transcription regulator TAOK3 51347 220761_s_at 1.195 2 Cytoplasm kinase Tap — 17 Unknown complex TBC1D8 11138 204526_s_at 1.373 3 Plasma other Membrane TCERG1 10915 — 8 Nucleus transcription regulator TCF7L2 6934 — 6 Nucleus transcription regulator TCOF1 (includes 6949 202385_s_at 1.169 1 Nucleus transporter EG: 6949) TCR — 2 Unknown complex TERF2 7014 — 5 Nucleus other TH1L 51497 — 3 Nucleus other THAP7 80764 — 1 Nucleus other THRAP3 9967 217847_s_at 1.464 1 Nucleus transcription regulator TIMP1 7076 — 9 Extracellular other Space TNF 7124 — 4 Extracellular cytokine adalimumab, Space etanercept, infliximab, CDP870, golimumab, thalidomide TNRC6A 27327 234734_s_at 1.268 9 Nucleus other TP53 7157 — 5 Nucleus transcription regulator TP53BP1 7158 — 5 Nucleus transcription regulator TPM4 7171 235094_at 2.079 8 Cytoplasm other Trans- — 15 Unknown group hexaprenyl- transtransferase TRIM33 51592 239716_at 2.496 6 Nucleus transcription regulator TRIO 7204 240773_at 2.607 2 Plasma kinase Membrane tRNA — 19 Unknown group adenylyl- transferase tRNA — 19 Unknown group cytidylyl- transferase TRNT1 51095 243236_at 2.295 19 Cytoplasm enzyme TRPV1 7442 1556229_at 2.636 2 Plasma ion channel SB-705498, Membrane capsaicin TSG101 7251 — 5, 7 Nucleus transcription regulator TSPAN7 7102 — 7 Plasma other Membrane TTC3 7267 208664_s_at 1.396 7 Cytoplasm other TXNL1 9352 243664_at 1.98 9 Cytoplasm enzyme Ubiquitin — 1 Unknown group UGT — 7 Unknown group UGT1A6 54578 206094_x_at 3.86 7 Cytoplasm enzyme USP36 57602 224979_s_at 1.393 18 Nucleus peptidase Vegf — 2 Unknown group VEGFA 7422 — 3 Extracellular growth factor bevacizumab, Space ranibizumab, pegaptanib VEGFB (includes 7423 — 3 Extracellular growth factor EG: 7423) Space VPS28 51160 — 5 Cytoplasm transporter VPS37B 79720 236889_at 2.85 5 Nucleus other WAS 7454 — 11 Cytoplasm other WDR68 10238 233782_at 1.924 4 Cytoplasm other WFS1 7466 1555270_a_at 1.315 3 Cytoplasm enzyme WIPF2 147179 216006_at 2.916 11 Unknown other WT1 7490 — 6 Nucleus transcription regulator WTAP 9589 1560274_at 1.747 2 Nucleus other XRCC5 7520 232633_at 2.106 5 Nucleus enzyme YWHAG 7532 — 4 Cytoplasm other ZEB1 6935 — 5 Nucleus transcription regulator ZFHX3 463 215828_at 1.737 5 Nucleus transcription regulator ZFR 51663 238970_at 2.655 Nucleus other ZFX 7543 207920_x_at 1.625 9 Nucleus transcription regulator ZMYND8 23613 209049_s_at 1.102 7 Nucleus transcription regulator ZNF224 7767 216983_s_at 2.986 6 Nucleus other ZNF226 7769 219603_s_at 1.332 8 Nucleus transcription regulator ZNF326 284695 241720_at 1.418 Nucleus transcription regulator ZNF536 9745 233890_at 3.303 Unknown other ZWINT (includes 11130 — 3 Nucleus other EG: 11130)

TABLE 4 Cell Surface Genes Entrez Gene ID for Human Name Location 7204 TRIO Plasma Membrane 1956 EGFR Plasma Membrane 7102 TSPAN7 Plasma Membrane 977 CD151 Plasma Membrane 2064 ERBB2 Plasma Membrane 2321 FLT1 Plasma Membrane 2030 SLC29A1 Plasma Membrane 11171 STRAP Plasma Membrane 8828 NRP2 Plasma Membrane 4233 MET Plasma Membrane 273 AMPH Plasma Membrane 351 APP Plasma Membrane 1756 DMD Plasma Membrane 1495 CTNNA1 Plasma Membrane 8727 CTNNAL1 Plasma Membrane 10211 FLOT1 Plasma Membrane 3459 IFNGR1 Plasma Membrane 23396 PIP5K1C Plasma Membrane 5663 PSEN1 Plasma Membrane 6445 SGCG Plasma Membrane 6693 SPN Plasma Membrane 6711 SPTBN1 Plasma Membrane 6840 SVIL Plasma Membrane 2057 EPOR Plasma Membrane 5789 PTPRD Plasma Membrane 4352 MPL Plasma Membrane 5786 PTPRA Plasma Membrane 27020 NPTN Plasma Membrane 3690 ITGB3 Plasma Membrane 7442 TRPV1 Plasma Membrane 8639 AOC3 Plasma Membrane 1131 CHRM3 Plasma Membrane 3804 KIR2DL3 Plasma Membrane 287 ANK2 Plasma Membrane 3071 NCKAP1L Plasma Membrane 5791 PTPRE Plasma Membrane 5802 PTPRS Plasma Membrane 6305 SBF1 Plasma Membrane 6328 SCN3A Plasma Membrane 6442 SGCA Plasma Membrane 6443 SGCB Plasma Membrane 66035 SLC2A11 Plasma Membrane 29988 SLC2A8 Plasma Membrane 6521 SLC4A1 Plasma Membrane 6809 STX3 Plasma Membrane 11138 TBC1D8 Plasma Membrane

A used herein “CSC-associated gene” refers to a gene whose expression or function is altered in cancer stem cells. CSC-associated genes include genes whose expression is signficantly altered, e.g., significantly upregulated or significantly downregulated, in cancer stem cells compared with non-cancer stem cells, e.g., cancer cells that are not stem cells, normal cells, etc. In some embodiments, genes that have significantly altered expression levels in cancer stem cells are identified by using an appropriate statistical test for establishing the significance of differences between expression levels in a cancer stem cell and a non-cancer stem cell. Tests for statistical significance are well known in the art and are exemplified in Applied Statistics for Engineers and Scientists by Petruccelli, Chen and Nandram 1999 Reprint Ed. The magnitude of up-, or down-, regulated expression of a CSC-associated gene in a cancer stem cell compared with a non-cancer stem cell may vary. In some embodiments, the expression level of a CSC-associated gene is at least 10%, at least 25%, at least 50%, at least 100%, at least 250%, at least 500%, or at least 1000% higher, or lower, than its expression level in a non-cancer stem cell. In other embodiments, the expression level of a CSC-associated gene is at least 2-fold, at least 3-fold, at least 4-fold, at least 5-fold, at least 6-fold, at least 7-fold, at least 8-fold, at least 9-fold, at least 10-fold, at least 20-fold, at least 30-fold, at least 40-fold, at least 50-fold, at least 100-fold, or more higher, or lower, than its expression level a non-cancer stem cell.

CSC-associated genes are not limited to genes which are upregulated or downregulated in cancer stem cells. In some embodiments, a CSC-associated gene is a gene that may or may not have altered expression in a cancer stem cell, but that nevertheless functions in a pathway that is deregulated in cancer stem cells. Typically, deregulated pathways in cancer stem cells involve the product(s) of one or more genes whose expression is upregulated or downregulated and/or the product(s) of one or more genes with altered functionality, e.g., due to a mutation, thereby resulting in altered function of the pathway, e.g., overactivity or underactivity of the pathway.

In some embodiments, CSC-associated genes are identified in cancer stem cells of a breast cancer, prostate cancer, colon cancer, lung cancer, renal cancer or melanoma. In some instances, CSC-associated genes are identified in cancer stem cells of a melanoma, which are also referred to as malignant melanoma initiating cells (MMIC). Other cancer stem cells (e.g., non-ABCB5 CSCs) are known in the art.

Exemplary CSC-associated genes are disclosed in Tables 1-8. In some embodiments, a CSC-associated gene is selected from the group consisting of: ANK2, NCKAP1L, PTPRE, PTPRS, SBF1, SCN3A, SGCA, SGCB, SLC2A11, SLC2A8, SLC4A1, STX3, and TBC1D8. In some embodiments, the CSC-associated gene is one that is not a gene of the group consisting of EGFR, CD151, ERBB2, FLT1, SLC29A1, NRP2, MET, AMPH, APP, DMD, and ITGB3. In some embodiments, the CSC-associated gene is one that is not a gene of the group consisting of: TRIO, TSPAN7, STRAP, CTNNA1, CTNNAL1, FLOT1, IFNGR1, PIP5K1C, PSEN1, SGCG, SPN, SPTBN1, SVIL, EPOR, PTPRD, MPL, PTPRA, NPTN, TRPV1, AOC3, CHRM3, and KIR2DL3. In some embodiments, the CSC-associated gene is one that is not a gene that has previously been indicated as a tumor suppressor or oncogene. In some embodiments, the CSC-associated gene is one that is not a gene of the group consisting of: EWSR1, TP53, EGFR, ITPR1, NBR1, MLL, PTK2, PTPN14, RB1, JARID1A, SKIL, TNF, TP53BP1, TRIO, SF1, TAF15, NCOA3, RAD54L, CUL4A, SMARCA5, RAD50, AKAP9, DENND4A, DDX17, HECW1, ZMYND8, ANAPC13, ANAPC5, TH1L, TRIM33, and CHD8. In some embodiments, the CSC-associated gene is one that is not a gene of the group consisting of: BARD1, BCL2, CBS, CTNNB1, ERBB2, EWSR1, HPS1, IFNG, IL1B, PTEN, TP53, VEGFA, CHEK2, and HPS4.

In part, the disclosure relates to CSC-associated genes as well as the RNAs and polypeptides (CSC-associated RNA and polypeptides) that they encode and antibodies and antigen-binding fragments that specifically bind them. The CSC-associated genes, RNAs and polypeptides, encompass variants, homologues, and fragments. Variants may result from alternative splicing or allelic variation of certain genes provided in Tables 5. In general, homologues and alleles typically will share at least 90% nucleotide identity and/or at least 95% amino acid identity to the sequences of the cancer antigen nucleic acids and polypeptides, respectively, in some instances will share at least 95% nucleotide identity and/or at least 97% amino acid identity, in other instances will share at least 97% nucleotide identity and/or at least 98% amino acid identity, in other instances will share at least 99% nucleotide identity and/or at least 99% amino acid identity, and in other instances will share at least 99.5% nucleotide identity and/or at least 99.5% amino acid identity. Homology can be calculated using various, publicly available software tools known in the art, such as those developed by NCBI (Bethesda, Md.) that are available through the internet. Exemplary tools include the BLAST system (e.g., using the default nucleic acid (Blastn) or protein (Blastp) search parameters) available from the website of the National Center for Biotechnology Information (NCBI) at the National Institutes of Health.

The CSC-associated genes are, among other things, useful for diagnosing cancer, such as breast cancer, prostate cancer, colon cancer, lung cancer, renal cancer or melanoma. Because CSC-associated gene expression is altered in cancer (e.g., upregulated or downregulated), the expression level of CSC-associated gene(s), e.g., a gene listed in Table 5 or 7, in an individual is diagnostic of cancer in that individual. Accordingly, the diagnostic methods disclosed herein can involve determining the CSC-associated RNA or protein (polypeptide) levels.

The term “individual” as used herein means any mammalian individual or subject, including, e.g., humans and non-human mammals, such as primates, rodents, and dogs. Individuals specifically intended for diagnosis and treatment using the methods described herein are preferably humans.

The expression level of CSC-associated gene(s) may be determined by using any of a number of methods known in the art. In some embodiments, the expression levels are determined from a biological sample (e.g., a test sample) obtained from a individual (e.g., a human). Exemplary, biological samples include an isolated cell, an isolated tissue, saliva, gingival secretions, cerebrospinal fluid (spinal fluid), gastrointestinal fluid, mucus, urogenital secretions, synovial fluid, blood, serum, plasma, urine, cystic fluid, lymph fluid, ascites, pleural effusion, interstitial fluid, intracellular fluid, ocular fluids, seminal fluid, mammary secretions, vitreal fluid, and nasal secretions. However, biological samples are not so limited and other exemplary biological specimens will be readily apparent to one of ordinary skill in the art. For the purposes of diagnosing melanoma, for example, the biological sample is preferably a skin tissue sample, e.g., a skin biopsy containing a suspicious lesion.

Expression levels of CSC-associated genes may be determined for diagnostic purposes using nucleic acid hybridization or nucleic acid amplification to detect the mRNAs that they encode. Methods for nucleic acid hybridization or amplification are well known in the art. In some embodiments, the nucleic acid amplification is real-time RT-PCR or RT-PCR. Other methods known to one of ordinary skill in the art could be employed to analyze mRNA levels, for example nucleic acid arrays, cDNA analysis, Northern analysis, and RNase Protection Assays. Nucleic acid arrays may be used to assay (e.g., for diagnostic purposes) the expression levels of multiple CSC-associated genes in parallel. Other suitable nucleic acid detection methods will be apparent to the skilled artisan.

Expression levels of CSC-associated genes may be determined for diagnostic purposes by detecting the polypeptides that they encode. Methods for detecting polypeptides are well known in the art. Exemplary polypeptide detection methods include, but are not limited to, Enzyme Linked Immunosorbent Assays (ELISA), radioimmunoassays (RIA), sandwich immunometric assays, flow cytometry, western blot assays, immunoprecipitation assays, immunohistochemistry, immunomicroscopy, lateral flow immuno-chromatographic assays, BIACORE technology, and proteomics methods, such as mass spectroscopy. Antibody arrays may be used to assay (e.g., for diagnostic purposes) the expression levels of multiple CSC-associated genes in parallel. Other suitable polypeptide detection methods will be apparent to the skilled artisan.

In some embodiments, e.g., where polypeptide, antibody or nucleic acid arrays are used, expression levels of up to 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127, 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 158, 159, 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197, 198, 199, 200, 201, 202, 203, 204, 205, 206, 207, 208, 209, 210, 211, 212, 213, 214, 215, 216, 217, 218, 219, 220, 221, 222, 223, 224, 225, 226, 227, 228, 229, 230, 231, 232, 233, 234, 235, 236, 237, 238, 239, 240, 241, 242, 243, 244, 245, 246, 247, 248, 249, 250, 251, 252, 253, 254, 255, 256, 257, 258, 259, 260, 261, 262, 263, 264, 265, 266, 267, 268, 269, 270, 271, 272, 273, 274, 275, 276, 277, 278, 279, 280, 281, 282, 283, 284, 285, 286, 287, 288, 289, 290, 291, 292, 293, 294, 295, 296, 297, 298, 299, 300, 301, 302, 303, 304, 305, 306, 307, 308, 309, 310, 311, 312, 313, 314, 315, 316, 317, 318, 319, 320, 321, 322, 323, 324, 325, 326, 327, 328, 329, 330, 331, 332, 333, 334, 335, 336, 337, 338, 339, 340, 341, 342, 343, 344, 345, 346, 347, 348, 349, 350, 351, 352, 353, 354, 355, 356, 357, 358, 359, 360, 361, 362, 363, 364, 365, 366, 367, 368, 369, 370, 371, 372, 373, 374, 375, 376, 377, 378, 379, 380, 381, 382, 383, 384, 385, 386, 387, 388, 389, 390, 391, 392, 393, 394, 395, 396, 397, 398, 399, or more CSC-associated genes may be tested in parallel.

The diagnostic methods of the invention involve a comparison between expression levels of CSC-associated genes in a test sample and a reference value. The results of the comparison are diagnostic of cancer, e.g., melanoma. In some embodiments, the reference value is the expression level of the gene in a reference sample. A reference value may be a predetermined value and may also be determined from reference samples (e.g., control biological samples) tested in parallel with the test samples. A reference value may be a positive or negative control level. A reference value can be a single cut-off value, such as a median or mean or a range of values, such as a confidence interval. Reference values can be established for various subgroups of individuals, such as individuals predisposed to cancer, individuals having early or late stage cancer, male and/or female individuals, or individuals undergoing cancer therapy. The level of the reference value will depend upon the particular population or subgroup selected. For example, an apparently healthy population will have a different “normal” value than will a population which has cancer, or a population that has a predisposition for cancer. Appropriate ranges and categories for reference values can be selected with no more than routine experimentation by those of ordinary skill in the art.

The reference sample can be any of a variety of biological samples against which a diagnostic assessment may be made. Examples of reference samples include biological samples from control populations or control samples. Reference samples may be generated through manufacture to be supplied for testing in parallel with the test samples, e.g., reference sample may be supplied in diagnostic kits. When the reference sample is from a cancer, e.g., tumor tissue, the expression level of the reference sample (the reference value) is the expression level of the CSC-associated gene in the cancer. Similarly, when the reference sample is a normal sample, e.g., non-tumor tissue, the expression level of the reference sample (the reference value) is the expression level of the CSC-associated gene in the non-tumor tissue. Similarly, when the reference sample is a cancer stem cell sample, the expression level of the reference sample (the reference value) is the expression level of the CSC-associated gene in the cancer stem cell sample. In some embodiments, the reference sample is of a melanoma and the expression level of the reference sample is the expression level of the CSC-associated gene in melanoma. In some embodiments, the reference sample is of a non-melanoma tissue and the expression level of the reference sample is the expression level of the CSC-associated gene in non-melanoma tissue. Other appropriate reference samples will be apparent to the skilled artisan.

The diagnostic methods are based in part on a comparison of expression levels of CSC-associated genes between test samples and reference sample. In some embodiments, if the expression level of the CSC-associated gene in the test sample is about equal to the expression level of the CSC-associated gene in the reference sample, then the test sample and reference sample are likely of a similar origin, category or class. For example, if expression levels in a test sample and reference sample are about the same (e.g., not statistically significantly different), and the reference sample is from a normal tissue, then the test sample is likely a normal tissue sample, and a normal diagnosis could be indicated. Alternatively, if expression levels in a test sample and reference sample are about the same, and the reference sample is from a cancer tissue, then the test sample is likely a cancer sample, and a diagnosis of cancer could be indicated. In certain embodiments, if the expression level in a test sample and reference sample are about the same, and the reference sample is from a melanoma, then the test sample is likely a melanoma sample, and a diagnosis of melanoma could be indicated.

In some cases, depending on factors such as the particular CSC-associated gene(s) being evaluated, the condition being diagnosed, and the type of reference sample, an expression level of a CSC-associated gene in a test sample that is statistically significantly higher or statistically significantly lower than its expression level in a reference sample indicates a diagnosis. For example, when the CSC-associated gene is among those listed in Table 1 or 8 and the reference value is the expression level of the CSC-associated gene in a normal (e.g., non-cancerous) reference sample, if the expression level of the CSC-associated gene in the test sample is significantly higher than the expression level of the CSC-associated gene in the normal reference sample, the comparison indicates cancer, e.g., melanoma. Similarly, when the CSC-associated gene is among those listed in Table 1 or 8 and the reference value is the expression level of the CSC-associated gene in a cancer, e.g., melanoma, reference sample, if the expression level of the CSC-associated gene in the test sample is significantly lower than the expression level of the CSC-associated gene in the cancer reference sample, the comparison does not indicate cancer. Alternatively, when the CSC-associated gene is among those listed in Table 2 or 7 and the reference value is the expression level of the CSC-associated gene in a normal reference sample, if the expression level of the CSC-associated gene in the test sample is significantly lower than the expression level of the CSC-associated gene in the normal reference sample, the comparison indicates cancer. Similarly, when the CSC-associated gene is in Table 2 or 7 and the reference value is the expression level of the CSC-associated gene in a cancer, e.g., melanoma, reference sample, if the expression level of the CSC-associated gene in the test sample is significantly higher than the expression level of the CSC-associated gene in the cancer reference sample, the comparison does not indicate melanoma. Appropriate combinations of particular CSC-associated gene(s), conditions to be diagnosed, and types of reference samples, can be selected with no more than routine experimentation by those of ordinary skill in the art for use in the diagnostic methods disclosed herein.

The magnitude of the difference between the test sample and reference sample that is sufficient to indicate a diagnosis will depend on a variety of factors such as the particular CSC-associated gene(s) being evaluated, the condition being diagnosed, heterogeneity in healthy or disease populations from which samples are drawn, the type of reference sample, the magnitude of expression level of a CSC-associated gene, the assay being used, etc. It is well within the purview of the skilled artisan to determine the appropriate magnitude of difference between the test sample and reference sample that is sufficient to indicate a diagnosis. In some embodiments, the expression level of the CSC-associated gene in the test sample is at least 10%, at least 20%, at least 50%, at least 100%, at least 200%, at least 500%, at least 1000% or more higher than the expression level of the gene in the reference sample. In other embodiments, the expression level of the CSC-associated gene in the test sample is at least 10%, at least 20%, at least 50%, at least 100%, at least 200%, at least 500%, at least 1000% or more lower than the expression level of the gene in the reference sample.

Some CSC-associated genes that are normally produced in very low quantities but whose production is dramatically increased in tumor cells, e.g., a CSC-associated gene in Table 1 or 8, can trigger an immune response. Thus, in some instances, specific immunoreactivity against a CSC-associated polypeptide, e.g., a polypeptide encoded by a gene listed in Table 1 or 8, in a individual may be diagnostic of cancer in the individual. Immunoreactivity against CSC-associated polypeptides may be humoral or cellular, and is associated with a specific immune response to a CSC-associated polypeptide that is upregulated in a cancer stem cell in an individual. In the case of a humoral response the diagnostic methods may involve detecting the presence of one or more antibodies in an individual that specifically bind CSC-associated polypeptides. Methods for detecting antibodies are disclosed herein (e.g., ELISA, peptide arrays, etc.) and are well known in the art. In some cases, the presence of CSC-polypeptide specific effector cells is diagnostic of an immune response specific to that CSC-polypeptide.

T Lymphocytes recognize complexes of peptide ligands (e.g., CSC-associated polypeptides) and Major Histocompatibility Complex (MHC) molecules presented at the surface of Antigen Presenting Cells (APC). Class I tetramers bind to a distinct set of T cell receptors (TCRs) on a subset of CD8+ T cells, and Class II tetramers bind to a distinct population of CD4+ T cells. Methods for detecting antigen-specific T cells using MHC tetramers are well known in the art (e.g., New Microarray Detects Antigen-Specific T Cells and Immune Responses. PLoS Biol 1(3): e76 2003) and can be used to detect CSC-polypeptide specific T cells which may be diagnostic of cancer in an individual. ITAG reagents, for example, from Beckman Coulter provide a convenient way to measure the cellular response directed toward a single CSC-associated peptide using MHC tetramers.

The methods for evaluating expression of CSC-associated genes, e.g., diagnostic methods, disclosed herein may be combined with methods for treating an individual having or suspected of having cancer. The treatment may comprise a step of determining the expression level of the CSC-associated gene in the individual. The treatment may also comprise a step of comparing the expression level of the CSC-associated gene to a reference value, such that the results of the comparison are diagnostic of cancer in the individual. In certain cases, if the comparison results in a diagnosis of cancer in the individual, the administering step is performed. In some cases, after a diagnosis is made using the methods disclosed herein, a treatment plan is selected. For example, if a diagnostic assay reveals that the expression of a particular CSC-associated gene is altered, e.g., increased or decreased, compared to a normal reference sample, then a treatment directed at that particular CSC-associated gene may be implemented. The diagnostic methods can also be used to evaluate the response to a treatment. For example, the determining and the comparing may be repeated at one or more intervals after the administering step to evaluate the response to the treatment.

CSC-associated polypeptide arrays and arrays of antibodies that bind CSC-associated polypeptides may be constructed by immobilizing large numbers of isolated CSC associated polypeptides or antibodies, or antigen binding fragments, to a solid support. Methods for producing polypeptide and antibody arrays are well known in the art. The methods typically involve production of proteins (CSC-associated polypeptides or antibodies) from an expression library, cloned into E. coli, yeast, or mammalian cells, or similar system, e.g., hybridomas etc., from which the expressed proteins are then purified, for example via His, GST tag, or Protein A/G affinity purification. Cell free protein transcription/translation is an alternative for synthesis of proteins which do not express well in bacterial or other in vivo systems. The purified isolated CSC associated polypeptides or antibodies are immobilized on the array surface (solid support surface) using art known methods. For example, proteins can be immobilized by adsorption, covalent (e.g., aldehydes) and non-covalent (e.g., biotin-streptavidin) interactions. Other methods of conjugation will be readily apparent to one of ordinary skill in the art. In some embodiments, the polypeptide arrays of the invention consist essentially of at least 2, at least 5, at least 10, at least 20, at least 50, at least 100, or more polypeptides or immunogenic fragments thereof encoded by a CSC-associated gene set forth in Table 1, 5, 7, or 8. In some embodiments, the antibody arrays of the invention consist essentially of at least 2, at least 5, at least 10, at least 20, at least 50, at least 100, or more different antibodies or antigen-binding fragments that specifically bind polypeptides (CSC-associated polypeptides) encoded by a CSC-associated gene set forth in Table 1, 5, 7, or 8.

Methods for producing nucleic acid arrays are well known in the art. Nucleic acid arrays may be constructed by, e.g., immobilizing to a solid support large numbers oligonucleotides, polynucleotides, or cDNAs having sequences complementary to CSC-associated mRNAs. The skilled artisan is also referred to Chapter 22 “Nucleic Acid Arrays” of Current Protocols In Molecular Biology (Eds. Ausubel et al. John Wiley and #38; Sons NY, 2000), International Publication WO00/58516, U.S. Pat. Nos. 5,677,195 and 5,445,934 which provide exemplary methods relating to nucleic acid array construction and use in detection of nucleic acids of interest. In some embodiments, the nucleic acid arrays consist essentially of at least 2, at least 5, at least 10, at least 20, at least 50, at least 100, at least 200, at least 300, or more of the CSC-associated genes set forth in Table 1, 5, 7, or 8.

In some embodiments, the expression levels of multiple CSC-associated genes may be combined to produce an expression profile. As used herein, “expression profile” refers to a set of expression levels of a plurality (e.g., 2 or more) of CSC-associated genes. Expression profiles have a variety of uses. For example, expression profiles may be used to classify (or sub-classify) a sample, preferably a clinical sample. In some embodiments, reference samples, for which a classification, e.g., a disease category, e.g., breast cancer, prostate cancer, melanoma, etc., has already been ascertained, are used to produce known expression profiles. In some embodiments, the similarity of an expression profile of a test sample and a known expression profile, is assessed by comparing the level of the same CSC-associated gene in the test and known expression profiles (i.e., expression level pairs). In some cases, a test expression profile is compared with one or more members of a plurality of known expression profiles, and a known expression profile that most closely resembles (i.e., is most similar to) the test profile is identified. In certain cases, the classification of a known expression profile that is identified as similar to a test expression profile is assigned to the test expression profile, thereby classifying the clinical sample associated with the test expression profile. The methods are useful for classifying samples across a range of phenotypes, e.g., disease status, risk status, etc., based on expression profiles. In some embodiments, a classification model (e.g., discriminant function, naïve bayes, support vector machine, logistic regression, and others known in the art) may be built based on the reference expression profiles from various samples from individuals known to have different disorders (e.g., cancers) and/or from healthy individuals, and used to classify subsequently obtained samples (e.g., clinical samples).

The invention also provides methods for stratifying a population comprising individuals having cancer. In some embodiments, methods involve determining expression levels of at least 2, at least 5, at least 10, at least 20, at least 50, at least 100, at least 200, at least 300, or more of the CSC-associated genes set forth in Table 5, 7, or 8, for example, by using the arrays of the invention, and stratifying the population based on the expression levels. The stratification methods are useful in epidemiological studies, for example, to identify subpopulations of individuals at risk of cancer. The methods are also useful in clinical studies to identify patient subpopulations that respond better or worse to a particular treatment.

In some aspects, CSC-associated genes provide a basis for identifying, isolating, cloning, propagating, and expanding CSC populations in vitro. The present invention contemplates any suitable method of employing agents, e.g., isolated peptides, e.g., antibodies, that bind to CSC-associated polypeptides to separate CSCs from other cells. Accordingly, included in the present invention is a method of producing a population of isolated CSCs. The methods involve contacting a sample, e.g., a cell suspension, with one or a combination of agents, e.g., antibodies or antigen binding fragments or ligands, which recognize and bind to an epitope, e.g., a cell surface protein, including CSC-associated polypeptides (e.g., polypeptides encoded by the genes listed in Table 4), on the CSC and separating and recovering from the sample the cells bound by the agents. The CSC-associated polypeptide may be encoded by a CSC-associated gene that is selected from the group consisting of: ANK2, NCKAP1L, PTPRE, PTPRS, SBF1, SCN3A, SGCA, SGCB, SLC2A11, SLC2A8, SLC4A1, STX3, and TBC1D8.

In some instances, commerically available antibodies or antibody fragments that bind CSC-associated polypeptides may be used in the methods disclosed herein. For example, antibodies against ANK2 include, e.g., rabbit anti-human Ankyrin brain polyclonal antibody from Abcam; mouse anti-human ANK2 monoclonal antibody clone 2.2 from Genway Biotech, Inc.; and mouse anti-human Ankyrin, brain variant 2 (ANK2) monoclonal, clone 2.20 and rabbit anti-human ankyrin, brain variant 2 (ank2) polyclonal from Lifespan Biosciences. Antibodies against NCKAP1L include, e.g., rabbit anti-human HEM1 polyclonal antibody from Proteintech Group, Inc. and are described in Weiner O D, et al., (2006) Hem-1 Complexes Are Essential for Rac Activation, Actin Polymerization, and Myosin Regulation during Neutrophil Chemotaxis. PLoS Biol 4(2): e38. Antibodies against PTPRE include, e.g., rabbit anti-PTPepsilon C-term RB0551-0552 polyclonal antibody from Abgent, mouse anti-human PTPRE polyclonal antibody from Abnova Corporation; mouse anti-PTPRE monoclonal antibody Clone 2D10 from Abnova Corporation; chicken anti-human PTPRE polyclonal antibody from Thermo Scientific; and Rabbit Anti-Protein Tyrosine phosphatase epsilon (PTPRE) antibody from Acris Antibodies GmbH. Antibodies against PTPRS include, e.g., mouse anti-PTPRS monoclonal antibody from Abcam; mouse anti-human PTPRS monoclonal antibody Clone 1H6 from Abnova Corporation; chicken anti-human PTPRS polyclonal antibody from ABR-Affinity Bioreagents, now sold as Thermo Scientific; chicken anti-human PTPRS polyclonal antibody from GeneTex; and mouse anti-human PTPRS monoclonal antibody, Clone 1H6 from GeneTex. Antibodies against SCN3A include, e.g., rabbit anti-SCN3A polyclonal antibody from Abcam; mouse anti-human SCN3A monoclonal antibody Clone 3F3 from Abnova Corporation; and mouse Anti-human SCN3A monoclonal antibody Clone 3F3 from GeneTex. Antibodies against SCNB include, e.g., mouse anti-beta Sarcoglycan Monoclonal Antibody from Abcam; mouse anti-human SGCB monoclonal antibody Clone 1C10 from Abnova Corporation; mouse anti-human SGCB monoclonal antibody Clone 1C10 from GeneTex; and rabbit anti-human Beta-sarcoglycan (SGCB) Polyclonal from Lifespan Biosciences. Antibodies against SLC2A8 include, e.g., rabbit anti-human Glucose Transporter 8 Polyclonal Antibody from Abcam; goat anti-GLUT8/SLC2A8 polyclonal antibody from Everest Biotech; rabbit anti-GLUCOSE TRANSPORTER 8 Polyclonal Antibody from GenWay Biotech, Inc.; rabbit Anti-Human GLUCOSE TRANSPORTER 5, C Terminus Polyclonal Antibody from GenWay Biotech, Inc.; goat anti-SLC2A8 polyclonal antibody from IMGENEX; and rabbit anti-Human Solute Carrier Family 2 (Facilitated Glucose Transporter) Member 8 (Slc2a8) polyclonal from Lifespan Biosciences. Antibodies against SBF1 include, e.g., rabbit Anti-MTMRS C-term RB0717 polyclonal antibody from Abgent. Antibodies against SGCA include, e.g., mouse Anti-SGCA monoclonal antibody Clone 3C4 from Abnova Corporation; rabbit Anti-Human SGCA polyclonal antibody from Atlas Antibodies; mouse Anti-SGCA monoclonal antibody clone 3C4 from Novus Biologicals; rabbit Anti-Human SGCA PRESTIGE ANTIBODIES from Sigma-Aldrich. Antibodies against SLC2A11 include, e.g., rabbit anti-human Solute Carrier Family 2 (Facilitated Glucose Transporter), Member 11 (Slc2a11) polyclonal from Lifespan Biosciences. Antibodies against SLC4A1 include, e.g., rabbit anti-human Band 3, N Terminus polyclonal antibody from Abcam; mouse anti-human SLC4A1 MaxPab® polyclonal antibody from Abnova Corporation; rabbit anti-human SLC4A1 polyclonal antibody from Aviva Systems Biology; mouse anti-Band 3 Monoclonal Antibody Clone BIII 136 from GenWay Biotech, Inc.; and mouse anti-human Solute Carrier Family 4, Anion Exchanger, Member 1 (SLC4A1) monoclonal Clone 3 h3 from Lifespan Biosciences. Antibodies against STX3 include, e.g., rabbit anti-human STX3 Polyclonal Antibody from Atlas Antibodies and rabbit anti-human STX3 from Sigma-Aldrich. Antibodies against TBC1D8 include, e.g., mouse anti-human TBC1D8 monoclonal antibody Clone 1A12 from Abnova Corporation; mouse anti-human TBC1D8 monoclonal antibody Clone 1A12 from GeneTex; mouse anti-human TBC1D8 monoclonal antibody Clone SS-18 from Santa Cruz Biotechnology, Inc.; and rabbit anti-human TBC1D8, aa 132-231 polyclonal antibody from Strategic Diagnostics, Inc.

Agents may be linked to a solid-phase and utilized to capture CSCs from a sample. The bound cells may then be separated from the solid phase by known methods depending on the nature of the agent, e.g., antibody, and solid phase. Alternatively, the agents may be conjugated to a detectable label, e.g., a fluorophore, that can be utilized to separate cells in a liquid phase, such as by fluorescent activated cell sorting. Exemplary fluorophores are well known in the art (e.g., Invitrogen's MOLECULAR PROBES technologies) and include FITC, TRITC, Cy3, Cy5, Alexa Fluorescent Dyes, and Quantum Dots.

Systems appropriate for preparing the desired cell population include magnetic bead/paramagnetic particle column utilizing isolated peptides that bind CSC-associated polypeptides for either positive or negative selection; separation based on biotin or streptavidin affinity; and high speed flow cytometric sorting of immunofluorescent-stained CSCs mixed in a suspension of other cells. Thus, the methods of the present invention include the isolation of a population of CSCs.

Isolated CSCs may be prepared as substantially pure preparations. The term “substantially pure” means that a preparation is substantially free of other cells. For example, an isolated CSC should constitute at least 70 percent of the total cells present with greater percentages, e.g., at least 85, 90, 95 or 99 percent, being preferred. The cells may be packaged in a finished container such as a cryovial along with any other components that may be desired, e.g., agents for preserving cells, or reducing bacterial growth. The CSCs are useful for a variety of purposes. The isolated cells may be used in basic research setting and in screening assays to identify compounds or compositions that affect growth of CSCs.

Isolated CSCs, prepared according to the methods disclosed herein, may be useful in a drug discovery context for lead compound identification and optimization in cell-based screens. For example, the effect of a compound on the growth and/or survival of a CSC may be determined in a cell-based screen that uses an assay selected from: a cell counting assay, a replication labeling assay, a cell membrane integrity assay, a cellular ATP-based viability assay, a mitochondrial reductase activity assay, a caspase activity assay, an Annexin V staining assay, a DNA content assay, a DNA degradation assay, and a nuclear fragmentation assay. Other exemplary assays include BrdU, EdU, or H3-Thymidine incorporation assays; DNA content assays using a nucleic acid dye, such as Hoechst Dye, DAPI, Actinomycin D, 7-aminoactinomycin D or Propidium Iodide; Cellular metabolism assays such as AlamarBlue, MTT, XTT, and CellTitre Glo; Nuclear Fragmentation Assays; Cytoplasmic Histone Associated DNA Fragmentation Assay; PARP Cleavage Assay; TUNEL staining; and Annexin staining.

In some aspects, the agents for isolating CSCs are antibody or antigen-binding fragments. The antibodies and antigen binding fragments of the invention include monoclonal antibodies, polyclonal antibodies, human antibodies, chimeric antibodies, humanized antibodies, single-chain antibodies, F(ab′)₂, Fab, Fd, Fv, or single-chain Fv fragments.

Other aspects of the invention relate to treatment methods. In some embodiments, the methods involve modulating, e.g., inducing or inhibiting, the activity of CSC-associated genes (RNA or protein) and, thereby, inhibiting the growth and survival of cancer stem cells. In some embodiments, the treatment methods involve selective delivery, e.g., by antibodies or antigen-binding fragments, of therapeutic agents to cancer stem cells. The methods are useful for inhibiting the proliferation and/or survival of cancer stem cells and, therefore, are useful for treating cancer, e.g., melanoma. The level of modulation, e.g., inducing or inhibiting, of the activity of a CSC-associated gene that is sufficient to affect the growth and/or survival of a cancer stem cell compared with a control level depends on a variety of factors, including the particular CSC-associated gene being modulated, the cancer stem cell within which the modulation occurs, and the level of expression in the control sample. It is well within the purview of the skilled artisan to determine the appropriate level of modulation that is sufficient to sufficient to inhibit the growth and/or survival of a cancer stem cell.

The term “inhibiting” refers to any decrease in expression level or activity. As used herein, “inhibit”, “suppress”, or “reduce” may, or may not, be complete. For example, cell proliferation, may, or may not, be decreased to a state of complete arrest for an effect to be considered one of suppression, inhibition or reduction of cell proliferation. Moreover, “suppress”, “inhibit”, or “reduce” may comprise the maintenance of an existing state and the process of effecting a change in state. For example, inhibition of cell proliferation may refer to the prevention of proliferation of a non-proliferating cell (maintenance of a non-proliferating state) and the process of inhibiting the proliferation of a proliferating cell (process of affecting a proliferation state change). Similarly, inhibition of cell survival may refer to killing of a cell, or cells, such as by necrosis or apoptosis, and the process of rendering a cell susceptible to death, such as by inhibiting the expression or activity of an anti-apoptotic regulatory factor. The suppression, inhibition, or reduction may be at least about 5%, 10%, 15%, 20%, 25%, 30%, 35%, 40%, 45%, 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, 99% of control level (e.g., an untreated state). In some cases, the level of modulation (e.g., suppression, inhibition, or reduction) compared with a control level is statistically significant. “Statistically signficant” is a term well known in the art and, for example, may refer to a p-value of less than 0.05, e.g., a p-value of less than 0.025 or a p-value of less than 0.01, using an appropriate statistical test (e.g., ANOVA, MANOVA, t-test, multiple comparison test, etc.).

The methods involve treating an individual having, or at risk of having, cancer. As used herein an “individual at risk of having cancer” is an individual, e.g., a human, with an increased likelihood of having cancer compared with a control population, e.g., a general population. Any one of a number of risk factors known in the art may be evaluated to determine whether or not an individual is at risk of having cancer. For example, factors that render an individual at risk of having melanoma include, for example, UV exposure, family history of melanoma, personal history of melanoma, fair skin, freckles, high numbers of nevi (moles), light hair, age, gender, and Xeroderma pigmento sum.

The treatment methods disclosed herein may involve administering a therapeutically effective amount of a composition that induces the expression of a CSC-associated gene which is downregulated in cancer (e.g., a gene in Table 2 or 7). In some instances, the composition that induces expression of a CSC-associated gene comprises a vector, such as an isolated plasmid, that expresses the CSC-associated gene.

As used herein, a “vector” may be any of a number of nucleic acid molecules into which a desired sequence may be inserted by restriction and ligation for transport between different genetic environments or for expression in a host cell. Vectors are typically composed of DNA although RNA vectors are also available. Vectors include, but are not limited to, plasmids, phagemids and virus genomes or portions thereof.

An expression vector is one into which a desired sequence may be inserted, e.g., by restriction and ligation such that it is operably joined to regulatory sequences and may be expressed as an RNA transcript. Vectors may further contain one or more marker sequences suitable for use in the identification of cells that have or have not been transformed or transfected with the vector. Markers include, for example, genes encoding proteins that increase or decrease either resistance or sensitivity to antibiotics or other compounds, genes that encode enzymes whose activities are detectable by standard assays known in the art (e.g., β-galactosidase or alkaline phosphatase), and genes that visibly affect the phenotype of transformed or transfected cells, hosts, colonies or plaques (e.g., green fluorescent protein).

Methods for identifying and obtaining coding sequences for use in the methods disclosed herein are routine in the art. For example, the skilled artisan may search Entrez Gene database using a GeneID or GeneAlias of a CSC-associated gene, e.g., a GeneID listed in Table 5, 7 or 8, to identify transcripts associated with CSC-associated genes. In most cases, links to commercial suppliers (e.g., Open Biosystems) of cDNA's containing the transcripts are provided in the Entrez Gene webinterface, which can be utilized to procure a copy cDNA clone. In other cases, commerical sources (e.g., Sigma Aldrich) can be contacted directly.

As used herein, a coding sequence and regulatory sequences are said to be “operably” joined when they are covalently linked in such a way as to place the expression or transcription of the coding sequence under the influence or control of the regulatory sequences. If it is desired that the coding sequences be translated into a functional protein, two DNA sequences are said to be operably joined if induction of a promoter in the 5′ regulatory sequences results in the transcription of the coding sequence and if the nature of the linkage between the two DNA sequences does not (1) result in the introduction of a frame-shift mutation, (2) interfere with the ability of the promoter region to direct the transcription of the coding sequences, or (3) interfere with the ability of the corresponding RNA transcript to be translated into a protein. Thus, a promoter region would be operably joined to a coding sequence if the promoter region were capable of effecting transcription of that DNA sequence such that the resulting transcript might be translated into the desired protein or polypeptide. It will be appreciated that a coding sequence need not encode a protein but may instead, for example, encode a functional RNA such as an shRNA.

The precise nature of the regulatory sequences needed for gene expression may vary between species or cell types, but shall in general include, as necessary, 5′ non-transcribed and 5′ non-translated sequences involved with the initiation of transcription and translation respectively, such as a TATA box, capping sequence, CAAT sequence, and the like. Such 5′ non-transcribed regulatory sequences will include a promoter region that includes a promoter sequence for transcriptional control of the operably joined gene. Regulatory sequences may also include enhancer sequences or upstream activator sequences as desired. The vectors of the invention may optionally include 5′ leader or signal sequences. The choice and design of an appropriate vector is within the ability and discretion of one of ordinary skill in the art. One of skill in the art will be aware of appropriate regulatory sequences for expression of interfering RNA, e.g., shRNA, miRNA, etc.

In some embodiments, a virus vector for delivering a nucleic acid molecule, an isolated plasmid, is selected from the group consisting of adenoviruses, adeno-associated viruses, poxviruses including vaccinia viruses and attenuated poxviruses, Semliki Forest virus, Venezuelan equine encephalitis virus, retroviruses, Sindbis virus, and Ty virus-like particle. Examples of viruses and virus-like particles which have been used to deliver exogenous nucleic acids include: replication-defective adenoviruses (e.g., Xiang et al., Virology 219:220-227, 1996; Eloit et al., J. Virol. 7:5375-5381, 1997; Chengalvala et al., Vaccine 15:335-339, 1997), a modified retrovirus (Townsend et al., J. Virol. 71:3365-3374, 1997), a nonreplicating retrovirus (Irwin et al., J. Virol. 68:5036-5044, 1994), a replication defective Semliki Forest virus (Zhao et al., Proc. Natl. Acad. Sci. USA 92:3009-3013, 1995), canarypox virus and highly attenuated vaccinia virus derivative (Paoletti, Proc. Natl. Acad. Sci. USA 93:11349-11353, 1996), non-replicative vaccinia virus (Moss, Proc. Natl. Acad. Sci. USA 93:11341-11348, 1996), replicative vaccinia virus (Moss, Dev. Biol. Stand. 82:55-63, 1994), Venzuelan equine encephalitis virus (Davis et al., J. Virol. 70:3781-3787, 1996), Sindbis virus (Pugachev et al., Virology 212:587-594, 1995), lentiviral vectors (Naldini L, et al., Proc Natl Acad Sci USA. 1996 Oct. 15; 93(21):11382-8) and Ty virus-like particle (Allsopp et al., Eur. J. Immunol 26:1951-1959, 1996).

Another virus useful for certain applications is the adeno-associated virus, a double-stranded DNA virus. The adeno-associated virus is capable of infecting a wide range of cell types and species and can be engineered to be replication-deficient. It further has advantages, such as heat and lipid solvent stability, high transduction frequencies in cells of diverse lineages, including hematopoietic cells, and lack of superinfection inhibition thus allowing multiple series of transductions. The adeno-associated virus can integrate into human cellular DNA in a site-specific manner, thereby minimizing the possibility of insertional mutagenesis and variability of inserted gene expression. In addition, wild-type adeno-associated virus infections have been followed in tissue culture for greater than 100 passages in the absence of selective pressure, implying that the adeno-associated virus genomic integration is a relatively stable event. The adeno-associated virus can also function in an extrachromosomal fashion.

Other useful viral vectors are based on non-cytopathic eukaryotic viruses in which non-essential genes have been replaced with the gene of interest. Non-cytopathic viruses include certain retroviruses, the life cycle of which involves reverse transcription of genomic viral RNA into DNA with subsequent proviral integration into host cellular DNA. In general, the retroviruses are replication-deficient (i.e., capable of directing synthesis of the desired transcripts, but incapable of manufacturing an infectious particle). Such genetically altered retroviral expression vectors have general utility for the high-efficiency transduction of genes in vivo. Standard protocols for producing replication-deficient retroviruses (including the steps of incorporation of exogenous genetic material into a plasmid, transfection of a packaging cell lined with plasmid, production of recombinant retroviruses by the packaging cell line, collection of viral particles from tissue culture media, and infection of the target cells with viral particles) are provided in Kriegler, M., “Gene Transfer and Expression, A Laboratory Manual,” W.H. Freeman Co., New York (1990) and Murry, E. J. Ed. “Methods in Molecular Biology,” vol. 7, Humana Press, Inc., Clifton, N.J. (1991).

In some embodiments, isolated plasmid vectors comprises a tumor-specific, e.g., melanoma-specific, e.g., a tyrosinase promoter, operably linked to the CSC-associated gene (See, e.g., Lillehammer, T. et al., Cancer Gene Therapy (2005) 12, 864-872). Other exemplary tumor-specific promoters are known in the art and will be apparent to the skilled artisan.

The treatment methods may involve administering a therapeutically effective amount of a composition that targets a product of a CSC-associated gene (i.e., Table 1), which are CSC-associated genes that upregulated in cancer stem cells. The composition may target a product of a CSC-associated gene selected from the group set forth in Table 4, which are upregulated in cancer stem cells and are associated with the cell surface.

The product, e.g., mRNA or protein, of a CSC-associated gene can be targeted by any one of a number of methods known in the art. For example, the composition may comprise a gene knockdown reagent, e.g., siRNA, that is complementary to a CSC-associated mRNA and inhibits its expression. In other embodiments, the composition may comprise an isolated molecule, e.g., antibody or antigen binding fragment, that is conjugated to a siRNA and that specifically binds to a CSC-associated polypeptide. Such antibody conjugated siRNAs (or similar gene suppression agents) may target a CSC-associated mRNA such as any of those encoded by the genes set forth in Table 1.

The CSC-associated gene may be selected from the following group ANK2, NCKAP1L, PTPRE, PTPRS, SBF1, SCN3A, SGCA, SGCB, SLC2A11, SLC2A8, SLC4A1, STX3, and TBC1D8 which are upregulated in cancer stem cells and associated with the cell surface. The siRNA may target another gene in the cell that is useful for inhibiting the growth and/or survival of the cell, for example an oncogene. For example, oncogenes that may be targeted include FOS, JUN MYB, RAS, and ABU Other exemplary oncogenes are well known in the art and several such examples are described in, for example. The Genetic Basis of Human Cancer (Vogelstein, B. and Kinzler, K. W. eds. McGraw-Hill, New York. N. Y., 1998). Other upregulated genes include Epidermal growth factor (beta-urogastrone, HOMG4/URG); Heparanase (HPA/HPR1); Jagged 1 (Alagille syndrome, AGS/AHD); Platelet/endothelial cell adhesion molecule (CD31 antigen, CD31/PECAM-1); Transforming growth factor, alpha (TFGA); and Vascular endothelial growth factor C (Flt4-L/VRP). Homologues of such genes can also be used.

Various strategies for gene knockdown known in the art can be used to inhibit gene expression (e.g., expression of CSC-associated genes). For example, gene knockdown strategies may be used that make use of RNA interference (RNAi) and/or microRNA (miRNA) pathways including small interfering RNA (siRNA), short hairpin RNA (shRNA), double-stranded RNA (dsRNA), miRNAs, and other small interfering nucleic acid-based molecules known in the art. In one embodiment, vector-based RNAi modalities (e.g., shRNA or shRNA-mir expression constructs) are used to reduce expression of a gene (e.g., a CSC-associated) in a cell. In some embodiments, therapeutic compositions of the invention comprise an isolated plasmid vector (e.g., any isolated plasmid vector known in the art or disclosed herein) that expresses a small interfering nucleic acid such as an shRNA. The isolated plasmid may comprise a tumor-specific, e.g., melanoma-specific, promoter operably linked to a gene encoding the small interfering nucleic acid, e.g., an shRNA. In some cases, the isolated plasmid vector is packaged in a virus capable of infecting the individual. Exemplary viruses include adenovirus, retrovirus, lentivirus, adeno-associated virus, and others that are known in the art and disclosed herein.

A broad range of RNAi-based modalities could be employed to inhibit expression of a gene in a cell, such as siRNA-based oligonucleotides and/or altered siRNA-based oligonucleotides. Altered siRNA based oligonucleotides are those modified to alter potency, target affinity, safety profile and/or stability, for example, to render them resistant or partially resistant to intracellular degradation. Modifications, such as phosphorothioates, for example, can be made to oligonucleotides to increase resistance to nuclease degradation, binding affinity and/or uptake. In addition, hydrophobization and bioconjugation enhances siRNA delivery and targeting (De Paula et al., RNA. 13(4):431-56, 2007) and siRNAs with ribo-difluorotoluyl nucleotides maintain gene silencing activity (Xia et al., ASC Chem. Biol. 1(3):176-83, (2006)). siRNAs with amide-linked oligoribonucleosides have been generated that are more resistant to S1 nuclease degradation than unmodified siRNAs (Iwase R et al. 2006 Nucleic Acids Symp Ser 50: 175-176). In addition, modification of siRNAs at the 2′-sugar position and phosphodiester linkage confers improved serum stability without loss of efficacy (Choung et al., Biochem. Biophys. Res. Commun. 342(3):919-26, 2006). Other molecules that can be used to inhibit expression of a gene (e.g., a CSC-associated gene) include sense and antisense nucleic acids (single or double stranded), ribozymes, peptides, DNAzymes, peptide nucleic acids (PNAs), triple helix forming oligonucleotides, antibodies, and aptamers and modified form(s) thereof directed to sequences in gene(s), RNA transcripts, or proteins. Antisense and ribozyme suppression strategies have led to the reversal of a tumor phenotype by reducing expression of a gene product or by cleaving a mutant transcript at the site of the mutation (Carter and Lemoine Br. J. Cancer. 67(5):869-76, 1993; Lange et al., Leukemia. 6(11):1786-94, 1993; Valera et al., J. Biol. Chem. 269(46):28543-6, 1994; Dosaka-Akita et al., Am. J. Clin. Pathol. 102(5):660-4, 1994; Feng et al., Cancer Res. 55(10):2024-8, 1995; Quattrone et al., Cancer Res. 55(1):90-5, 1995; Lewin et al., Nat Med. 4(8):967-71, 1998). Ribozymes have also been proposed as a means of both inhibiting gene expression of a mutant gene and of correcting the mutant by targeted trans-splicing (Sullenger and Cech Nature 371(6498):619-22, 1994; Jones et al., Nat. Med. 2(6):643-8, 1996). Ribozyme activity may be augmented by the use of, for example, non-specific nucleic acid binding proteins or facilitator oligonucleotides (Herschlag et al., Embo J. 13(12):2913-24, 1994; Jankowsky and Schwenzer Nucleic Acids Res. 24(3):423-9, 1996). Multitarget ribozymes (connected or shotgun) have been suggested as a means of improving efficiency of ribozymes for gene suppression (Ohkawa et al., Nucleic Acids Symp Ser. (29):121-2, 1993).

Triple helix approaches have also been investigated for sequence-specific gene suppression. Triple helix forming oligonucleotides have been found in some cases to bind in a sequence-specific manner (Postel et al., Proc. Natl. Acad. Sci. U.S.A. 88(18):8227-31, 1991; Duval-Valentin et al., Proc. Natl. Acad. Sci. U.S.A. 89(2):504-8, 1992; Hardenbol and Van Dyke Proc. Natl. Acad. Sci. U.S.A. 93(7):2811-6, 1996; Porumb et al., Cancer Res. 56(3):515-22, 1996). Similarly, peptide nucleic acids have been shown to inhibit gene expression (Hanvey et al., Antisense Res. Dev. 1(4):307-17, 1991; Knudsen and Nielson Nucleic Acids Res. 24(3):494-500, 1996; Taylor et al., Arch. Surg. 132(11):1177-83, 1997). Minor-groove binding polyamides can bind in a sequence-specific manner to DNA targets and hence may represent useful small molecules for suppression at the DNA level (Trauger et al., Chem. Biol. 3(5):369-77, 1996). In addition, suppression has been obtained by interference at the protein level using dominant negative mutant peptides and antibodies (Herskowitz Nature 329(6136):219-22, 1987; Rimsky et al., Nature 341(6241):453-6, 1989; Wright et al., Proc. Natl. Acad. Sci. U.S.A. 86(9):3199-203, 1989). In some cases suppression strategies have led to a reduction in RNA levels without a concomitant reduction in proteins, whereas in others, reductions in RNA have been mirrored by reductions in protein. The diverse array of suppression strategies that can be employed includes the use of DNA and/or RNA aptamers that can be selected to target a protein of interest (e.g, a CSC-associated polypeptide).

Methods of delivering a therapeutic agent to a cancer stem cell are also provided. The methods involve a step of contacting a cancer stem cell with an isolated molecule that selectively binds to a cell surface polypeptide encoded by a CSC-associated gene, such as those selected from the group set forth in Table 4. The CSC-associated gene may be selected from the group consisting of: ANK2, NCKAP1L, PTPRE, PTPRS, SBF1, SCN3A, SGCA, SGCB, SLC2A11, SLC2A8, SLC4A1, STX3, and TBC1D8. The cancer stem cell may be in vivo or in vitro. Isolated molecules that bind to CSC-associated polypeptides on the surface of a cancer stem cell may be taken up into an intracellular compartment of the cancer stem cell.

Cancer stem cells include stem cells of a colon carcinoma, a pancreatic cancer, a breast cancer, an ovarian cancer, a prostate cancer, a squamous cell carcinoma, a cervical cancer, a lung carcinoma, a small cell lung carcinoma, a bladder carcinoma, a squamous cell carcinoma, a basal cell carcinoma, an adenocarcinoma, a sweat gland carcinoma, a sebaceous gland carcinoma, a papillary carcinoma, a papillary adenocarcinoma, a cystadenocarcinoma, a medullary carcinoma, a bronchogenic carcinoma, a renal cancer, e.g., renal cell carcinoma, a hepatocellular carcinoma, a bile duct carcinoma, a choriocarcinoma, a seminoma, a embryonal carcinoma, a Wilms' tumor, or a testicular tumor. In specific embodiments, the cancer stem cells are stem cells of melanoma. Cancer stem cells include ABCB5⁺ cells and ABCB5⁻ cells. Stem cells of other cancers will be known to one of ordinary skill in the art.

The treatment methods of the invention involve administering compositions that comprise isolated molecules, or combinations of different isolated molecules, that specifically bind to CSC-associated polypeptides (polypeptides encoded by the CSC-associated gene) to treat cancer, e.g., melanoma, in an individual. When the CSC-associated polypeptide is associated with the extracellular surface of a cell, e.g., a cancer stem cell, e.g., a melanoma stem cell, the isolated molecule can bind the CSC-associated polypeptide and, for example, serve as an vehicle for specifically targeting therapeutic agents (therapeutic molecules) to the cell. In some embodiments, isolated molecules that binds to a CSC-associated polypeptide on the surface of a cell are taken up into an intracellular compartment of the cell bind to a secreted molecule, such as a growth factor that may assist the tumor (such as those listed in Table 1.2). The isolated molecules that interact with unregulated proteins may be used alone as therapeutics or in combination with other therapeutics.

As used herein treatment of or treating cancer includes preventing the development of a cancer, reducing the symptoms of a cancer and/or inhibiting, slowing the growth of or preventing further growth of an existing cancer. Treatment may include amelioration, cure, and/or maintenance of a cure (i.e., prevention or delay of relapse) of a disorder, e.g., cancer. Treatment after a disorder has started aims to reduce, ameliorate or altogether eliminate the disorder, and/or its associated symptoms, to prevent it from becoming worse, to slow the rate of progression, or to prevent the disorder from re-occurring once it has been initially eliminated (i.e., to prevent a relapse).

Cancers include for instance a colon carcinoma, a pancreatic cancer, a breast cancer, an ovarian cancer, a prostate cancer, a squamous cell carcinoma, a cervical cancer, a lung carcinoma, a small cell lung carcinoma, a bladder carcinoma, a squamous cell carcinoma, a basal cell carcinoma, an adenocarcinoma, a sweat gland carcinoma, a sebaceous gland carcinoma, a papillary carcinoma, a papillary adenocarcinoma, a cystadenocarcinoma, a medullary carcinoma, a bronchogenic carcinoma, a renal cell carcinoma, a hepatocellular carcinoma, a bile duct carcinoma, a choriocarcinoma, a seminoma, an embryonal carcinoma, a Wilms' tumor, or a testicular tumor. In certain embodiments, the cancer is melanoma.

The invention, in some aspects, relates to an isolated molecule that selectively binds to a polypeptide encoded by a CSC-associated gene set forth in Table 4 and that is conjugated to a therapeutic agent. In some instances, the CSC-associated gene is selected from the group consisting of: ANK2, NCKAP1L, PTPRE, PTPRS, SBF1, SCN3A, SGCA, SGCB, SLC2A11, SLC2A8, SLC4A1, STX3, and TBC1D8. Compositions comprising the foregoing isolated molecules are also disclosed.

As used herein an “isolated molecule” is a molecule such as a polypeptide, nucleic acid, polysaccharide, drug, nucleoprotein, lipoprotein, glycoprotein, steroid, and lipid that is isolated from its natural environment or produced synthetically. In some embodiments, the isolated molecule is a ligand of a CSC-associated polypeptide. In other embodiments, the isolated molecule is an antibody or antigen-binding fragment. As disclosed herein, antibody or antigen-binding fragments include monoclonal antibodies, polyclonal antibodies, human antibodies, chimeric antibodies, humanized antibodies, single-chain antibodies, F(ab′)₂, Fab, Fd, Fv, or single-chain Fv fragments. In some embodiments, an isolated molecule may have therapeutic utility alone and need not be conjugated to a therapeutic agent. For example, an isolated molecule may bind to a cell surface receptor that is a CSC-associated polypeptide and function as an antagonist or competitive inhibitor of the receptor (e.g., to inhibit a signaling pathway).

In some embodiments, isolated molecules are conjugated to therapeutic agents. As used herein, a “therapeutic agent” is a molecule such as a polypeptide, nucleic acid, polysaccharide, drug, nucleoprotein, lipoprotein, glycoprotein, steroid, and lipid that is capable of altering the state of a cell (e.g., killing a cell, inhibiting growth of a cell) for therapeutic purposes. A therapeutic agent may be, for instance, a toxin, a small-interfering nucleic acid, or a chemotherapeutic agent. Alternatively the therapeutic may be administered in conjunction with the molecule. In conjunction refers to delivery to the same subject. The actual administration may be at the same or a different time or in the same or a different delivery vehicle.

Toxins include for example, radioisotopes such as ²²⁵Ac, ²¹¹At, ²¹²Bi, ²¹³Bi, ¹⁸⁶Rh, ¹⁸⁸Rh, ¹⁷⁷Lu, ⁹⁰Y, ¹³¹I, ⁶⁷Cu, ¹²⁵I, ¹²³I, ⁷⁷Br, ¹⁵³Sm, ¹⁶⁶Bo, ⁶⁴Cu, ²¹²Pb, ²²⁴Ra and ²²³Ra, and others known in the art. Suitable chemical toxins include members of the enediyne family of molecules, such as calicheamicin and esperamicin as well as poisonous lectins, plant toxins such as ricin, abrin, modeccin, botulina and diphtheria toxins. Of course, combinations of the various toxins could also be coupled to one isolated molecule, e.g., an antibody, thereby accommodating variable cytotoxicity. The coupling of one or more toxin molecules to the isolated molecule, e.g., antibody, is envisioned to include many chemical mechanisms, for instance covalent binding, affinity binding, intercalation, coordinate binding, and complexation.

Chemotherapeutic agents include the following compounds or classes of compounds: Acivicin; Aclarubicin; Acodazole Hydrochloride; Acronine; Adozelesin; Adriamycin; Aldesleukin; Altretamine; Ambomycin; Ametantrone Acetate; Aminoglutethimide; Amsacrine; Anastrozole; Anthramycin; Asparaginase; Asperlin; Azacitidine; Azetepa; Azotomycin; Batimastat; Buniodepa; Bicalutamide; Bisantrene Hydrochloride; Bisnafide Dimesylate; Bizelesin; Bleomycin Sulfate; Brequinar Sodium; Bropirimine; Busulfan; Cactinomycin; Calusterone; Caracemide; Carbetimer; Carboplatin; Carmustine; Carubicin Hydrochloride; Carzelesin; Cedefingol; Chlorombucil; Cirolemycin; Cisplatin; Cladribine; Crisnatol Mesylate; Cyclophosphamide; Cytarabine; Dacarbazine; DACA (N-[2-(Dimethyl-amino)ethyl]acridine-4-carboxamide); Dactinomycin; Daunorubicin Hydrochloride; Daunomycin; Decitabine; Dexormaplatin; Dezaguanine; Dezaguanine Ifesylate; Diaziquone; Docetaxel; Doxorubicin; Doxorubicin Hydrochloride; Droloxifene; Droloxifene Citrate; Dromostanolone Propionate; Duazomycin; Edatrexate; Eflornithine Hydrochloride; Elsamitrucin; Enloplatin; Enpromate; Epipropidine; Epirubicin Hydrochloride; Erbulozole; Esorubicin Hydrochloride; Estramustine; Estramustine Phosphate Sodium; Etanidazole; Ethiodized Oil I 131; Etoposide; Etoposide Phosphate; Etoprine; Fadrozole Hydrochloride; Fazarabine; Fenretinide; Floxuridine; Fludarabine Phosphate; Fluorouracil; 5-FdUMP; Flurocitabine; Fosquidone; Fostriecin Sodium; Gemcitabine; Gemcitabine Hydrochloride; Gold Au 198; Hydroxyurea; Idarubicin Hydrochloride; Ifosfamide; Ilmofosine; Interferon Alfa-2a; Interferon Alfa-2b; Interferon Alfa-n1; Interferon Alfa-n3; Interferon Beta-1a; Interferon Gamma-1b; Iproplatin; Irinotecan Hydrochloride; Lanreotide Acetate; Letrozole; Leuprolide Acetate; Liarozole Hydrochloride; Lometrexol Sodium; Lomustine; Losoxantrone Hydrochloride; Masoprocol; Maytansine; Mechlorethamine Hydrochloride; Megestrol Acetate; Melengestrol Acetate; Melphalan; Menogaril; Mercaptopurine; Methotrexate; Methotrexate Sodium; Metoprine; Meturedepa; Mitindomide; Mitocarcin; Mitocromin; Mitogillin; Mitomalcin; Mitomycin, Mitosper; Mitotane; Mitoxantrone Hydrochloride; Mycophenolic Acid; Nocodazole; Nogalamycin; Ormaplatin; Oxisuran; Paclitaxel Pegaspargase; Peliomycin; Pentamustine; Peplomycin Sulfate; Perfosfamide; Pipobroman; Piposulfan; Piroxantrone Hydrochloride; Plicamycin; Plomestane; Porfimer Sodium; Porfiromycin; Prednimustine; Procarbazine Hydrochloride; Puromycin; Puromycin Hydrochloride; Pyrazofurin; Riboprine; Rogletimide; Safingol; Safingol Hydrochloride; Semustine; Simtrazene; Sparfosate Sodium; Sparsomycin; Spirogermanium Hydrochloride; Spiromustine; Spiroplatin; Streptonigrin; Streptozocin; Strontium Chloride Sr 89; Sulofenur; Talisomycin; Taxane; Taxoid; Tecogalan Sodium; Tegafur; Teloxantrone Hydrochloride; Temoporfin; Teniposide; Teroxirone; Testolactone; Thiamiprine; Thioguanine; Thiotepa; Thymitaq; Tiazofurin; Tirapazamine; Tomudex; TOP-53; Topotecan Hydrochloride; Toremifene Citrate; Trestolone Acetate; Triciribine Phosphate; Trimetrexate; Trimetrexate Glucuronate; Triptorelin; Tubulozole Hydrochloride; Uracil Mustard; Uredepa; Vapreotide; Verteporfin; Vinblastine; Vinblastine Sulfate; Vincristine; Vincristine Sulfate, Vindesine; Vindesine Sulfate; Vinepidine Sulfate; Vinglycinate Sulfate; Vinleurosine Sulfate; Vinorelbine Tartrate; Vinrosidine Sulfate; Vinzolidine Sulfate; Vorozole; Zeniplatin; Zinostatin; Zorubicin Hydrochloride; 2-Chlorodeoxyadenosine; 2′-Deoxyformycin; 9-aminocamptothecin; raltitrexed; N-propargyl-5, 8-dideazafolic acid, 2-chloro-2′-arabino-fluoro-2′-deoxyadenosine; 2-chloro-2′-deoxyadenosine; anisomycin; trichostatin A; hPRL-G129R; CEP-751; linomide; Piritrexim Isethionate; Sitogluside; Tamsulosin Hydrochloride and Pentomone.

The invention, in some aspects, provides kits comprising one or more containers housing one or more of the compositions of the invention. The kit may be designed to facilitate use of the methods described herein by researchers and can take many forms. Each of the compositions of the kit, where applicable, may be provided in liquid form (e.g., in solution), or in solid form, (e.g., a dry powder). In certain cases, some of the compositions may be constitutable or otherwise processable (e.g., to an active form), for example, by the addition of a suitable solvent or other species (for example, water or a cell culture medium), which may or may not be provided with the kit. The kits may also include reference samples. As used herein, “instructions” can define a component of instruction and/or promotion, and typically involve written instructions on or associated with packaging of the invention. Instructions also can include any oral or electronic instructions provided in any manner such that a user will clearly recognize that the instructions are to be associated with the kit, for example, audiovisual (e.g., videotape, DVD, etc.), Internet, and/or web-based communications, etc. The written instructions may be in a form prescribed by a governmental agency regulating the manufacture, use or sale of pharmaceuticals or biological products, which instructions can also reflects approval by the agency of manufacture, use or sale for animal administration.

The kit may contain any one or more of the components described herein in one or more containers. As an example, in one embodiment, the kit may include instructions for mixing one or more components of the kit and/or isolating and mixing a sample and applying to a individual. The kit may include a container housing agents described herein. The agents may be in the form of a liquid, gel or solid (powder). The agents may be prepared sterilely, packaged in syringe and shipped refrigerated. Alternatively it may be housed in a vial or other container for storage. A second container may have other agents prepared sterilely. Alternatively the kit may include the active agents premixed and shipped in a syringe, vial, tube, or other container. The kit may have one or more or all of the components required to administer the agents to an animal, such as a syringe, topical application devices, or iv needle tubing and bag, particularly in the case of the kits for treating individuals with cancer.

The compositions and therapeutic agents may be administered simultaneously or sequentially. When the other therapeutic agents are administered simultaneously they can be administered in the same or separate formulations, but are administered at the same time. The other therapeutic agents are administered sequentially with one another and with the modulators, when the administration of the other therapeutic agents and the modulators is temporally separated. The separation in time between the administration of these compounds may be a matter of minutes or it may be longer.

The compositions of the present invention preferably contain a pharmaceutically acceptable carrier or excipient suitable for rendering the compound or mixture administrable orally as a tablet, capsule or pill, or parenterally, intravenously, intradermally, intramuscularly or subcutaneously, or transdermally. The active ingredients may be admixed or compounded with any conventional, pharmaceutically acceptable carrier or excipient. The compositions may be sterile.

As used herein, the term “pharmaceutically acceptable carrier” includes any and all solvents, dispersion media, coatings, antibacterial and antifungal agents, isotonic agents, absorption delaying agents, and the like. The use of such media and agents for pharmaceutically active substances is well known in the art. Except insofar as any conventional media or agent is incompatible with the compositions of this invention, its use in the therapeutic formulation is contemplated. Supplementary active ingredients can also be incorporated into the pharmaceutical formulations. A composition is said to be a “pharmaceutically acceptable carrier” if its administration can be tolerated by a recipient patient. Sterile phosphate-buffered saline is one example of a pharmaceutically acceptable carrier. Other suitable carriers are well-known in the art.

It will be understood by those skilled in the art that any mode of administration, vehicle or carrier conventionally employed and which is inert with respect to the active agent may be utilized for preparing and administering the pharmaceutical compositions of the present invention. Illustrative of such methods, vehicles and carriers are those described, for example, in Remington's Pharmaceutical Sciences, 18th ed. (1990), the disclosure of which is incorporated herein by reference. Those skilled in the art, having been exposed to the principles of the invention, will experience no difficulty in determining suitable and appropriate vehicles, excipients and carriers or in compounding the active ingredients therewith to form the pharmaceutical compositions of the invention.

An effective amount, also referred to as a therapeutically effective amount is an amount sufficient to ameliorate at least one adverse effect associated with expression, or reduced expression, of a CSC-associated gene in a cell or in an individual in need of such inhibition or supplementation. The therapeutically effective amount to be included in pharmaceutical compositions depends, in each case, upon several factors, e.g., the type, size and condition of the patient to be treated, the intended mode of administration, the capacity of the patient to incorporate the intended dosage form, etc. Generally, an amount of active agent is included in each dosage form to provide from about 0.1 to about 250 mg/kg, and preferably from about 0.1 to about 100 mg/kg. One of ordinary skill in the art would be able to determine empirically an appropriate therapeutically effective amount.

Combined with the teachings provided herein, by choosing among the various active compounds and weighing factors such as potency, relative bioavailability, patient body weight, severity of adverse side-effects and preferred mode of administration, an effective prophylactic or therapeutic treatment regimen can be planned which does not cause substantial toxicity and yet is entirely effective to treat the particular individual. The effective amount for any particular application can vary depending on such factors as the disease or condition being treated, the particular therapeutic agent being administered, the size of the individual, or the severity of the disease or condition. One of ordinary skill in the art can empirically determine the effective amount of a particular nucleic acid and/or other therapeutic agent without necessitating undue experimentation.

The pharmaceutical compositions can be administered by any suitable route for administering medications. A variety of administration routes are available. The particular mode selected will depend, of course, upon the particular agent or agents selected, the particular condition being treated, and the dosage required for therapeutic efficacy. The methods of this invention, generally speaking, may be practiced using any mode of administration that is medically acceptable, meaning any mode that produces effective levels of an immune response without causing clinically unacceptable adverse effects. Preferred modes of administration are discussed herein. For use in therapy, an effective amount of the nucleic acid and/or other therapeutic agent can be administered to an individual by any mode that delivers the agent to the desired surface, e.g., mucosal, systemic.

Administering the pharmaceutical composition of the present invention may be accomplished by any means known to the skilled artisan. Routes of administration include but are not limited to oral, parenteral, intravenous, intramuscular, intraperitoneal, intranasal, sublingual, intratracheal, inhalation, subcutaneous, ocular, vaginal, and rectal. Systemic routes include oral and parenteral. Several types of devices are regularly used for administration by inhalation. These types of devices include metered dose inhalers (MDI), breath-actuated MDI, dry powder inhaler (DPI), spacer/holding chambers in combination with MDI, and nebulizers.

In some cases, compounds of the invention are prepared in a colloidal dispersion system. Colloidal dispersion systems include lipid-based systems including oil-in-water emulsions, micelles, mixed micelles, and liposomes. A preferred colloidal system of the invention is a liposome. Liposomes are artificial membrane vessels which are useful as a delivery vector in vivo or in vitro. It has been shown that large unilamellar vesicles (LUVs), which range in size from 0.2-4.0 μm can encapsulate large macromolecules. RNA, DNA and intact virions can be encapsulated within the aqueous interior and be delivered to cells in a biologically active form. Fraley et al. (1981) Trends Biochem Sci 6:77.

Liposomes may be targeted to a particular tissue by coupling the liposome to a specific binding molecule such as one that binds to a CSC-associated polypeptide. Binding molecules which may be useful for targeting a liposome to, for example, a cancer stem cell include, but are not limited to intact or fragments of molecules, e.g., antibodies or antigen binding fragments, which interact with CSC-associated polypeptides on the surface of cancer stem cells. Such binding molecules may easily be identified by binding assays well known to those of skill in the art.

Lipid formulations for transfection are commercially available from QIAGEN, for example, as EFFECTENE™ (a non-liposomal lipid with a special DNA condensing enhancer) and SUPERFECT™ (a novel acting dendrimeric technology).

Liposomes are commercially available from Gibco BRL, for example, as LIPOFECTIN™ and LIPOFECTACE™, which are formed of cationic lipids such as N-[1-(2, 3 dioleyloxy)-propyl]-N, N, N-trimethylammonium chloride (DOTMA) and dimethyl dioctadecylammonium bromide (DDAB). Methods for making liposomes are well known in the art and have been described in many publications. Liposomes also have been reviewed by Gregoriadis G (1985) Trends Biotechnol 3:235-241.

Certain cationic lipids, including in particular N-[1-(2, 3 dioleoyloxy)-propyl]-N,N,N-trimethylammonium methyl-sulfate (DOTAP), appear to be especially advantageous when combined with the modified oligonucleotide analogs of the invention.

In one embodiment, the vehicle is a biocompatible microparticle or implant that is suitable for implantation or administration to the mammalian recipient. Exemplary bioerodible implants that are useful in accordance with this method are described in PCT International application no. PCT/US/03307 (Publication No. WO95/24929, entitled “Polymeric Gene Delivery System”. PCT/US/0307 describes a biocompatible, preferably biodegradable polymeric matrix for containing an exogenous gene under the control of an appropriate promoter. The polymeric matrix can be used to achieve sustained release of the therapeutic agent in the individual.

The polymeric matrix preferably is in the form of a microparticle such as a microsphere (e.g., wherein a therapeutic agent is dispersed throughout a solid polymeric matrix) or a microcapsule (e.g., wherein a therapeutic agent is stored in the core of a polymeric shell). Other forms of the polymeric matrix for containing the therapeutic agent include films, coatings, gels, implants, and stents. The size and composition of the polymeric matrix device is selected to result in favorable release kinetics in the tissue into which the matrix is introduced. The size of the polymeric matrix further is selected according to the method of delivery which is to be used, typically injection into a tissue or administration of a suspension by aerosol into the nasal and/or pulmonary areas. Preferably when an aerosol route is used the polymeric matrix and the therapeutic agent are encompassed in a surfactant vehicle. The polymeric matrix composition can be selected to have both favorable degradation rates and also to be formed of a material which is bioadhesive, to further increase the effectiveness of transfer when the matrix is administered to a nasal and/or pulmonary surface that has sustained an injury. The matrix composition also can be selected not to degrade, but rather, to release by diffusion over an extended period of time. Biocompatible microspheres that are suitable for delivery, such as oral or mucosal delivery, are disclosed in Chickering et al. (1996) Biotech Bioeng 52:96-101 and Mathiowitz E et al. (1997) Nature 386:410-414 and PCT Pat. Application WO97/03702.

Both non-biodegradable and biodegradable polymeric matrices can be used to deliver the therapeutic agentsto an individual. Biodegradable matrices are preferred. Such polymers may be natural or synthetic polymers. The polymer is selected based on the period of time over which release is desired, generally in the order of a few hours to a year or longer. Typically, release over a period ranging from between a few hours and three to twelve months is most desirable, particularly for the nucleic acid agents. The polymer optionally is in the form of a hydrogel that can absorb up to about 90% of its weight in water and further, optionally is cross-linked with multi-valent ions or other polymers.

Bioadhesive polymers of particular interest include bioerodible hydrogels described by H. S. Sawhney, C. P. Pathak and J. A. Hubell in Macromolecules, (1993) 26:581-587, the teachings of which are incorporated herein. These include polyhyaluronic acids, casein, gelatin, glutin, polyanhydrides, polyacrylic acid, alginate, chitosan, poly(methyl methacrylates), poly(ethyl methacrylates), poly(butylmethacrylate), poly(isobutyl methacrylate), poly(hexylmethacrylate), poly(isodecyl methacrylate), poly(lauryl methacrylate), poly(phenyl methacrylate), poly(methyl acrylate), poly(isopropyl acrylate), poly(isobutyl acrylate), and poly(octadecyl acrylate).

If the therapeutic agent is a nucleic acid, the use of compaction agents may also be desirable. Compaction agents also can be used alone, or in combination with, a biological or chemical/physical vector. A “compaction agent”, as used herein, refers to an agent, such as a histone, that neutralizes the negative charges on the nucleic acid and thereby permits compaction of the nucleic acid into a fine granule. Compaction of the nucleic acid facilitates the uptake of the nucleic acid by the target cell. The compaction agents can be used alone, i.e., to deliver a nucleic acid in a form that is more efficiently taken up by the cell or, more preferably, in combination with one or more of the above-described vectors.

Other exemplary compositions that can be used to facilitate uptake of a nucleic acid include calcium phosphate and other chemical mediators of intracellular transport, microinjection compositions, electroporation and homologous recombination compositions (e.g., for integrating a nucleic acid into a preselected location within the target cell chromosome).

The compounds may be administered alone (e.g., in saline or buffer) or using any delivery vehicle known in the art. For instance the following delivery vehicles have been described: cochleates; Emulsomes; ISCOMs; liposomes; live bacterial vectors (e.g., Salmonella, Escherichia coli, Bacillus Calmette-Guérin, Shigella, Lactobacillus); live viral vectors (e.g., Vaccinia, adenovirus, Herpes Simplex); microspheres; nucleic acid vaccines; polymers (e.g. carboxymethylcellulose, chitosan); polymer rings; proteosomes; sodium fluoride; transgenic plants; virosomes; and, virus-like particles.

The formulations of the invention are administered in pharmaceutically acceptable solutions, which may routinely contain pharmaceutically acceptable concentrations of salt, buffering agents, preservatives, compatible carriers, adjuvants, and optionally other therapeutic ingredients.

The term pharmaceutically-acceptable carrier means one or more compatible solid or liquid filler, diluents or encapsulating substances which are suitable for administration to a human or other vertebrate animal. The term carrier denotes an organic or inorganic ingredient, natural or synthetic, with which the active ingredient is combined to facilitate the application. The components of the pharmaceutical compositions also are capable of being commingled with the compounds of the present invention, and with each other, in a manner such that there is no interaction which would substantially impair the desired pharmaceutical efficiency.

For oral administration, the compounds can be formulated readily by combining the active compound(s) with pharmaceutically acceptable carriers well known in the art. Such carriers enable the compounds of the invention to be formulated as tablets, pills, dragees, capsules, liquids, gels, syrups, slurries, suspensions and the like, for oral ingestion by an individual to be treated. Pharmaceutical preparations for oral use can be obtained as solid excipient, optionally grinding a resulting mixture, and processing the mixture of granules, after adding suitable auxiliaries, if desired, to obtain tablets or dragee cores. Suitable excipients are, in particular, fillers such as sugars, including lactose, sucrose, mannitol, or sorbitol; cellulose preparations such as, for example, maize starch, wheat starch, rice starch, potato starch, gelatin, gum tragacanth, methyl cellulose, hydroxypropylmethyl-cellulose, sodium carboxymethylcellulose, and/or polyvinylpyrrolidone (PVP). If desired, disintegrating agents may be added, such as the cross-linked polyvinyl pyrrolidone, agar, or alginic acid or a salt thereof such as sodium alginate. Optionally the oral formulations may also be formulated in saline or buffers for neutralizing internal acid conditions or may be administered without any carriers.

Dragee cores are provided with suitable coatings. For this purpose, concentrated sugar solutions may be used, which may optionally contain gum arabic, talc, polyvinyl pyrrolidone, carbopol gel, polyethylene glycol, and/or titanium dioxide, lacquer solutions, and suitable organic solvents or solvent mixtures. Dyestuffs or pigments may be added to the tablets or dragee coatings for identification or to characterize different combinations of active compound doses.

Pharmaceutical preparations which can be used orally include push-fit capsules made of gelatin, as well as soft, sealed capsules made of gelatin and a plasticizer, such as glycerol or sorbitol. The push-fit capsules can contain the active ingredients in admixture with filler such as lactose, binders such as starches, and/or lubricants such as talc or magnesium stearate and, optionally, stabilizers. In soft capsules, the active compounds may be dissolved or suspended in suitable liquids, such as fatty oils, liquid paraffin, or liquid polyethylene glycols. In addition, stabilizers may be added. Microspheres formulated for oral administration may also be used. Such microspheres have been well defined in the art. All formulations for oral administration should be in dosages suitable for such administration.

For buccal administration, the compositions may take the form of tablets or lozenges formulated in conventional manner.

For administration by inhalation, the compounds for use according to the present invention may be conveniently delivered in the form of an aerosol spray presentation from pressurized packs or a nebulizer, with the use of a suitable propellant, e.g., dichlorodifluoromethane, trichlorofluoromethane, dichlorotetrafluoroethane, carbon dioxide or other suitable gas. In the case of a pressurized aerosol the dosage unit may be determined by providing a valve to deliver a metered amount. Capsules and cartridges of e.g. gelatin for use in an inhaler or insufflator may be formulated containing a powder mix of the compound and a suitable powder base such as lactose or starch.

The compounds, when it is desirable to deliver them systemically, may be formulated for parenteral administration by injection, e.g., by bolus injection or continuous infusion. Formulations for injection may be presented in unit dosage form, e.g., in ampoules or in multi-dose containers, with an added preservative. The compositions may take such forms as suspensions, solutions or emulsions in oily or aqueous vehicles, and may contain formulatory agents such as suspending, stabilizing and/or dispersing agents.

Pharmaceutical formulations for parenteral administration include aqueous solutions of the active compounds in water-soluble form. Additionally, suspensions of the active compounds may be prepared as appropriate oily injection suspensions. Suitable lipophilic solvents or vehicles include fatty oils such as sesame oil, or synthetic fatty acid esters, such as ethyl oleate or triglycerides, or liposomes. Aqueous injection suspensions may contain substances which increase the viscosity of the suspension, such as sodium carboxymethyl cellulose, sorbitol, or dextran. Optionally, the suspension may also contain suitable stabilizers or agents which increase the solubility of the compounds to allow for the preparation of highly concentrated solutions.

Alternatively, the active compounds may be in powder form for constitution with a suitable vehicle, e.g., sterile pyrogen-free water, before use.

The compounds may also be formulated in rectal or vaginal compositions such as suppositories or retention enemas, e.g., containing conventional suppository bases such as cocoa butter or other glycerides.

In addition to the formulations described previously, the compounds may also be formulated as a depot preparation. Such long-acting formulations may be formulated with suitable polymeric or hydrophobic materials (for example as an emulsion in an acceptable oil) or ion exchange resins, or as sparingly soluble derivatives, for example, as a sparingly soluble salt.

The pharmaceutical compositions also may comprise suitable solid or gel phase carriers or excipients. Examples of such carriers or excipients include but are not limited to calcium carbonate, calcium phosphate, various sugars, starches, cellulose derivatives, gelatin, and polymers such as polyethylene glycols.

Suitable liquid or solid pharmaceutical preparation forms are, for example, aqueous or saline solutions for inhalation, microencapsulated, encochleated, coated onto microscopic gold particles, contained in liposomes, nebulized, aerosols, pellets for implantation into the skin, or dried onto a sharp object to be scratched into the skin. The pharmaceutical compositions also include granules, powders, tablets, coated tablets, (micro)capsules, suppositories, syrups, emulsions, suspensions, creams, drops or preparations with protracted release of active compounds, in whose preparation excipients and additives and/or auxiliaries such as disintegrants, binders, coating agents, swelling agents, lubricants, flavorings, sweeteners or solubilizers are customarily used as described above. The pharmaceutical compositions are suitable for use in a variety of drug delivery systems. For a brief review of methods for drug delivery, see Langer R (1990) Science 249:1527-1533, which is incorporated herein by reference.

The compounds may be administered per se (neat) or in the form of a pharmaceutically acceptable salt. When used in medicine the salts should be pharmaceutically acceptable, but non-pharmaceutically acceptable salts may conveniently be used to prepare pharmaceutically acceptable salts thereof. Such salts include, but are not limited to, those prepared from the following acids: hydrochloric, hydrobromic, sulphuric, nitric, phosphoric, maleic, acetic, salicylic, p-toluene sulphonic, tartaric, citric, methane sulphonic, formic, malonic, succinic, naphthalene-2-sulphonic, and benzene sulphonic. Also, such salts can be prepared as alkaline metal or alkaline earth salts, such as sodium, potassium or calcium salts of the carboxylic acid group.

Suitable buffering agents include: acetic acid and a salt (1-2% w/v); citric acid and a salt (1-3% w/v); boric acid and a salt (0.5-2.5% w/v); and phosphoric acid and a salt (0.8-2% w/v). Suitable preservatives include benzalkonium chloride (0.003-0.03% w/v); chlorobutanol (0.3-0.9% w/v); parabens (0.01-0.25% w/v) and thimerosal (0.004-0.02% w/v).

The compositions may conveniently be presented in unit dosage form and may be prepared by any of the methods well known in the art of pharmacy. All methods include the step of bringing the compounds into association with a carrier which constitutes one or more accessory ingredients. In general, the compositions are prepared by uniformly and intimately bringing the compounds into association with a liquid carrier, a finely divided solid carrier, or both, and then, if necessary, shaping the product. Liquid dose units are vials or ampoules. Solid dose units are tablets, capsules and suppositories.

Other delivery systems can include time-release, delayed release or sustained release delivery systems. Such systems can avoid repeated administrations of the compounds, increasing convenience to the individual and the physician. Many types of release delivery systems are available and known to those of ordinary skill in the art. They include polymer base systems such as poly(lactide-glycolide), copolyoxalates, polycaprolactones, polyesteramides, polyorthoesters, polyhydroxybutyric acid, and polyanhydrides. Microcapsules of the foregoing polymers containing drugs are described in, for example, U.S. Pat. No. 5,075,109. Delivery systems also include non-polymer systems that are: lipids including sterols such as cholesterol, cholesterol esters and fatty acids or neutral fats such as mono-, di-, and tri-glycerides; hydrogel release systems; silastic systems; peptide-based systems; wax coatings; compressed tablets using conventional binders and excipients; partially fused implants; and the like. Specific examples include, but are not limited to: (a) erosional systems in which an agent of the invention is contained in a form within a matrix such as those described in U.S. Pat. Nos. 4,452,775, 4,675,189, and 5,736,152, and (b) diffusional systems in which an active component permeates at a controlled rate from a polymer such as described in U.S. Pat. Nos. 3,854,480, 5,133,974 and 5,407,686. In addition, pump-based hardware delivery systems can be used, some of which are adapted for implantation.

EXAMPLES

Among the numerous CSC-associated genes are genes involved in vasculogenesis and angiogenesis. For example, global gene expression analyses validated by mRNA and protein determinations revealed preferential display of genes for vascular endothelial growth factor receptor-1 (VEGFR-1) and related members of signaling cascades involved in vasculogenesis and angiogenesis in ABCB5⁺ MMIC. In vitro, vascular endothelial growth factor (VEGF) induced expression of the endothelial-associated marker CD144 (VE-cadherin) in VEGFR-1-expressing ABCB5⁺ MMIC but not VEGFR-1-negative ABCB5⁻ melanoma bulk populations, indicating a unique capacity of CSC for VEGF/VEGFR-1 signaling-dependent vasculogenic differentiation. In vivo, tumors initiated from patient-derived melanoma cells or established melanoma cultures by xenotransplantation into the murine subcutis or by intradermal injection into human skin in chimeric murine recipients formed perfused ABCB5 mRNA- and protein-expressing vessel-like channels also detected in clinical melanoma specimens that co-expressed CD144 and the vasculogenic mimicry marker TIE-1⁴. Tumour initiation in human skin by fluorescent transgene-expressing human melanoma cells confirmed CD144⁺ channels to be of melanoma origin. Moreover, MMIC depletion in tumour grafts to human skin significantly reduced channel formation and resulted in attenuated tumour growth. Our results identify melanoma vasculogenesis driven by ABCB5⁺ MMIC as a novel mechanism by which CSC may promote tumor growth. Furthermore, they suggest that MMIC-dependent vasculogenesis represents a novel CSC target for VEGF/VEGFR-1-directed inhibitors of angiogenesis.

Example 1 Materials and Methods

Melanoma Cells and Culture Methods.

The established human cutaneous melanoma cell lines G3361, A375, MALME-3M, SK-MEL-2, SK-MEL-5, SK-MEL-28, UACC-62, UACC-257, M14 and MDA-MB-435 were cultured as described^(3,5,23). Clinical cutaneous melanoma cells were derived from surgical specimen according to human subjects research protocols approved by the IRBs of the University of Würzburg Medical School or the Wistar Institute, Philadelphia, Pa. as described previously³. The established human uveal melanoma cell lines MUM-2B and MUM-2C were a gift of Dr. Mary J. Hendrix, Northwestern University, and were cultured as described¹⁶.

Cell Isolation.

ABCB5⁺-purified (ABCB5⁺) cells were isolated by positive selection and ABCB5⁺-depleted (ABCB5⁻) cell populations were generated by removing ABCB5⁺ cells using anti-ABCB5 mAb (clone 3C2-1D12²³) labeling and magnetic bead cell sorting as described³. Briefly, human G3361, A375, MUM-2B or MUM-2C melanoma cells or single cell suspensions derived from clinical melanoma samples were labeled with anti-ABCB5 mAb for 30 min at 4° C., washed twice for excess antibody removal, followed by incubation with secondary anti-mouse IgG mAb-coated magnetic microbeads for 30 min at 4° C. Subsequently, cells were washed twice for excess magnetic microbead removal and then sorted into ABCB5⁺ and ABCB5⁻ cell fractions by dual-passage cell separation in MidiMACS or MiniMACS separation columns (depending on cell number) according to the manufacturer's recommendations (Miltenyi Biotec, Auburn, Calif.). Assessment of purity of ABCB5⁺ and ABCB5⁻ (ABCB5⁺ cell-depleted) melanoma cell isolates and determination of cell viability following magnetic cell sorting were performed and yielded similar results as described previously³.

Global Gene Expression Microarray Analyses.

Microarray analyses were performed on purified ABCB5⁺ (n=5) and ABCB5⁻ (n=5) cell subsets derived from the established human melanoma cell lines G3361 and A375 and from three distinct clinical melanoma specimen previously characterized in our laboratory with regards to ABCB5 expression and MMIC phenotype in human melanoma xenotransplantation assays³. Total RNA was extracted, processed and hybridized as described previously¹⁰ onto Affymetrix human HG-U133Plus2 GeneChip microarrays (Affymetrix, Santa Clara, Calif.). Statistical analysis of microarray results was performed as described previously¹⁰. The expression data set in its entirety will be made available through GEO (gene expression omnibus). Functional gene networks were generated using Ingenuity Pathways Analysis (Ingenuity® Systems, ingenuity.com), by mapping each gene identifier to its corresponding gene object in the Ingenuity Pathways Knowledge Base. These focus genes were overlaid onto a global molecular network developed from information contained in the Ingenuity Pathways Knowledge Base. Focus gene networks were then algorithmically generated based on their connectivity and subsequently analyzed to identify the biological functions that were most significant to the genes in the network.

RNA Extraction and Reverse Transcriptase-PCR.

Total RNA was isolated from ABCB5⁺ and ABCB5⁻ human melanoma cells using RNeasy columns (QIAGEN, Valencia, Calif.). Standard cDNA synthesis reactions were performed using 5 μg RNA and the SuperScript First-Strand Synthesis System for reverse transcriptase-PCR (Invitrogen, Carlsbad, Calif.) as per the manufacturer's instructions. For PCR analysis, 5 μl of diluted first strand product (˜100 ng of cDNA) was added to 45 μl of PCR reaction mixture containing 5 units of Superscript II (Invitrogen) according to the manufacturer's protocol. The following PCR program was performed: denaturation at 95° C. for 5 min, then cycled 35 times at 94° C. for 1 min, 53° C. for 30 s, and 72° C. for 30 s, and subsequently extended at 72° C. for 10 min. The primer sequences were as follows: PTK2 forward primer, 5′-TGCCTTTTACTTTCGTGTGG-3′(SEQ ID NO:1); PTK2 reverse primer 5′-CCAAATTCCTGTTTTGCTTCA-3′(SEQ ID NO:2); MET forward primer 5′-CCCCACCTTATCCTGACGTA-3′(SEQ ID NO:3); MET reverse primer 5′-CGTGTGTCCACCTCATCATC-3′(SEQ ID NO:4); NRP2 forward primer 5′-GAGGCAGGGGAAAATAGAGG-3′(SEQ ID NO:5); NRP2 reverse primer 5′-TCTCCCGAAAGGTTGAAATG-3′(SEQ ID NO:6); ETS1 forward primer 5′-CGCTTACTCTGTTGGGGTCT-3′(SEQ ID NO:7); ETS1 reverse primer 5′-TCTCCAGCAAAATGATGTGC-3′(SEQ ID NO:8); FLT1 forward primer 5′-TGGCAACTGCTTTTATGTTCTG-3′(SEQ ID NO:9); FLT1 reverse primer 5′-TCCATAGGGTGATGGTCAAA-3′(SEQ ID NO: 10). The reaction products were resolved on a 1% LE agarose gel (Ambion, Austin, Tex.) and photographed. β-Actin primers were used as controls to ensure RNA integrity.

RNA Extraction and Real Time Quantitative PCR.

Total RNA was isolated from unsegregated or sorted human melanoma cells using the RT² qPCR Grade RNA isolation kit (SABiosciences, Frederick, Md.). Standard cDNA synthesis reactions were performed using 1 μg RNA and the RT² First Strand Kit for reverse transcriptase-PCR (SABiosciences) as per the manufacturer's instructions. The reverse transcriptase product (1 μl) was amplified by primer pairs specific for ABCB5⁵. β-actin was used as a normalizing control. The primers for ABCB5 (Genebank accession no. AY234788) detection were 5′-GCTGAGGAATCCACCCAATCT-3′ (forward) (SEQ ID NO:11) and 5′-AGCCTGAATGGCCTTTTGTG-3′ (reverse) (SEQ ID NO:12). The primers for β-actin detection were 5′-CCTGGCACCCAGCACAAT-3′ (SEQ ID NO:13) (forward) and 5′-AGTACTCCGTGTGGATCGGC-3′ (reverse) (SEQ ID NO: 14). Samples were assayed using Sybergreen chemistry and kinetic PCR (ABI 7300 Sequence Detector; Applied Biosystems, Foster City, Calif.). Samples were amplified using the Sybergreen PCR reagent kit (Applied Biosystems) according to the manufacturer's protocol. Sense and antisense primers were used at a final concentration of 10 nM. The cDNA samples were amplified under following conditions: 50° C. for 2 min and 95° C. for 10 min, followed by 40 cycles of amplification at 94° C. for 15 s and 60° C. for 1 min. All samples were run in triplicate. The relative amounts of transcripts were analyzed using the 2(−Delta Delta C(T)) method as described previously^(3,5,10). Statistical differences between mRNA expression levels were determined using the nonparametric Mann-Whitney test. A two-sided P value of P<0.05 was considered significant.

Western Analysis.

Total cell lysates were harvested from logarithmically growing cultures of the human melanoma cell lines MALME-3M, SK-MEL-2, SK-MEL-5, SK-MEL-28, UACC-62, UACC-257, M14, and MDA-MB-435 and analyzed by 8% SDS-PAGE and Western assay to detect relative levels of ABCB5 (mAb 3C2-1D12²³) and alpha-tubulin (mAb clone DM1A, Sigma-Aldrich, St. Louis, Mo.), using LI-COR Odyssey IR imaging system densitometry.

Flow Cytometry.

G3361, A375, MUM-2B, or MUM-2C melanoma cells were analyzed for surface ABCB5 expression by incubation with anti-ABCB5 mAb or isotype control mAb for 30 min at 4° C., followed by counterstaining with FITC-conjugated goat anti-mouse Ig or with APC-conjugated donkey anti-mouse IgG secondary Abs and single color flow cytometry at the Fl1 (FITC) or F14 (APC) emission spectrum on a Becton Dickinson FACScan as described^(3,5,23). Washing was performed twice between each step. Analysis of coexpression of ABCB5 with the VEGFR-1 surface marker in G3361 melanoma cells was performed by dual-color flow cytometry as described³. Briefly, melanoma cells were incubated for 30 min at 4° C. with anti-ABCB5 mAb or isotype control mAb, followed by counterstaining with APC-conjugated donkey anti-mouse IgG secondary Ab as above. Subsequently, cells were fixed at 4° C. and then incubated for 30 min at 4° C. with PE-conjugated anti-VEGFR-1 mAb (R&D Systems, Minneapolis, Minn.) or PE-conjugated isotype control mAb (BD PharMingen, San Diego, Calif.). Dual color flow cytometry was subsequently performed with acquisition of fluorescence emission at the F14 (APC) and F12 (PE) spectra on a Becton Dickinson FACScan. Washing was performed twice between each step. Statistical differences between expression levels of markers were determined using the nonparametric Mann-Whitney test. A two-sided P value of P<0.05 was considered significant.

In Vitro Vasculogenic Differentiation and Tube Formation Assays.

VEGF-dependent induction of CD144 expression and formation of capillary-like tube structures by human G3361 melanoma cells was assayed on growth factor reduced Matrigel, a basement membrane matrix preparation (BD Biosciences, San Jose, Calif.). Growth factor reduced Matrigel was added to eight-chamber polystyrene vessel tissue culture-treated glass slides and allowed to gelatinize for 20 min at 37° C. Purified ABCB5⁺ or ABCB5⁻ or unsegregated human melanoma cells were seeded into culture slide wells at densities of 5×10⁴ cells/cm² in medium 199 containing 5% FCS¹¹ in the presence or absence of VEGF (100 ng/ml). After 48-hour incubation, cells were fixed with 4% paraformaldehyde/PBS for 20 min at room temperature, and after extensive washing with PBS the cells were blocked in 5% donkey serum/0.01% Tween 20/PBS for 1 hr at room temperature. Cells were then incubated with rabbit anti-CD144 polyclonal Ab (diluted 1:100; Bethyl Laboratories, Montgomery, Tex.) overnight at 4° C. After extensive washing with 0.01% Tween 20/PBS, the cells were incubated with goat anti-rabbit Texas red-conjugated secondary Ab (diluted 1:250; Jackson ImmunoResearch Laboratories, West Grove, Pa.) for 1 hr at room temperature. Following washing with 1×PBS/0.01% Tween 20, cells were then mounted in Vectashield (Vecta Laboratories, Burlingame, Calif.) supplemented with 100 ng/ml DAPI to visualize nuclei. Cells were analyzed by fluorescent microscopy using a Mercury-100 Watts fluorescent light source (Microvideo Instruments, Avon, Mass.) attached to a Nikon Eclipse TE 300 microscope (Nikon Instruments, Melville, N.Y.) with the use of separate filters for each fluorochrome. The images were obtained using a Spot digital camera (Diagnostic Instruments Inc., Sterling Heights, Mich.), and the Spot 3.3.2. software package was imported into Adobe Photoshop (Adobe Systems, Mountain View, Calif.). For tube formation assays, unsegregated human melanoma cells were seeded into culture slide wells at densities of 5×10⁴ cells/cm² in medium 199 containing 5% FCS¹¹. Immediately, cells were pretreated with medium alone, rabbit anti-VEGFR1 Ab (10 μg/ml; Santa Cruz Biotechnology, Santa Cruz, Calif.) or rabbit isotype control Ab (10 μg/ml; BD Biosciences) at 37° C. for 2 hrs prior to stimulation with VEGF (100 ng/ml). Tube formation was detected by phase contrast microscope (Nikon Eclipse TE 300 microscope) after 24 hrs of incubation. For quantitative analysis of tube formation and length and for determination of CD144 expression at 48 hrs, n=3 three randomly selected microscopy fields were photographed per experimental condition. Images were acquired as described above and tube formation was analyzed using Image J software available from the National Institutes of Health web site as described previously²⁴. For quantification of CD144 expression, positive cells were counted using Neurolucida 8.10 software (MBF Bioscience, Williston, Vt.). Differences among groups were analyzed by one-way ANOVA followed by Bonferroni post hoc tests. Differences with P values<0.05 were considered statistically significant.

In Vitro Adipogenic, Osteogenic and Myogenic Differentiation Assays.

For adipogenic, osteogenic and myogenic differentiation assays purified ABCB5⁺ and ABCB5⁻ G3361 melanoma cells were seeded in triplicate at 3×10³ cells/well in 96-well culture plates. Adipogenic and osteogenic differentiation was assessed using commercially available differentiation kits and Oil Red O and Alizarin Red staining, respectively, according to the manufacturer's instructions (Chemicon International, Temecula, Calif.). Myogenic differentiation assays were performed as described previously¹⁰. Briefly, melanoma subpopulations were incubated in growth medium consisting of DMEM with 4% glucose, 20% fetal bovine serum (vol/vol), 1% (vol/vol) penicillin-streptomycin (10,000 UI/ml-10,000 μg/ml, Invitrogen) for 10 days. The medium was exchanged every 2 days. At day 14, cells were fixed in ice cold methanol for 3 min on ice and incubated with 1:50 diluted anti-myogenin mouse monoclonal Ab (Dako, Carpinteria, Calif.) overnight at 4° C. Plates were then washed, incubated with goat anti-mouse FITC-conjugated secondary Ab (Jackson ImmunoResearch Laboratories, diluted 1:100) and then mounted with Vectashield mounting medium (Vector) supplemented with 100 ng/ml DAPI to visualize nuclei. Slides were visualized with the 20× and 40× objective on a Nikon Eclipse TE2000-S microscope, photographed using the Spot 7.4 slider camera and images processed using Spot software version 4.0.9. (Diagnostic Instruments, Sterling Heights, Mich.). For quantification of differentiation marker expression, positive cells were manually counted and statistical differences between expression levels of markers were determined using the nonparametric Mann-Whitney test. A two-sided P value of P<0.05 was considered significant.

Immunohistochemistry and Immunofluorescence Double Labeling.

The following primary Abs were used: rat anti-Laminin B2, (Abcam, Cambridge, Mass.), rabbit anti-CD144, (Cell Signaling, Beverly, Mass.), goat anti-Tie-1, (Neuromics, Edina, Minn.), and mouse anti-ABCB5^(3,5,23). Isotype matched irrelevant Abs served as negative control. The secondary Abs were horse anti-mouse IgG-HRP, horse anti-goat IgG-HRP, goat anti-rabbit IgG-HRP (VECTOR Laboratories, Burlingame, Calif.) and goat anti-rat IgG-HRP (Biolegend, San Diego, Calif.), and donkey anti-mouse IgG-AF488, donkey anti-rabbit IgG-AF594, and donkey anti-goat IgG-AF594 (Invitrogen, Carlsbad, Calif.). Immunohistochemistry was performed using the 2-step horseradish peroxidase method. Briefly, frozen tissue sections were fixed with −20° C. acetone for 5 min, then incubated with primary Ab at 4° C. overnight. After washing out unbound primary Ab with phosphate-buffered saline (PBS), the tissue sections were incubated with secondary Ab at room temperature for 30 min, then washed with PBS 3×5 min. Immunoreactivity was detected using NovaRed peroxidase substrate (VECTOR Laboratories, Burlingame, Calif.). For immunofluorescence double labeling, the frozen tissue sections were fixed with −20° C. acetone for 5 min, then incubated with the mix of 2 primary Abs (for example ABCB5 Ab+CD144 Ab) at 40° C. overnight. After washing with PBS, the tissue sections were incubated with the mix of 2 secondary Abs (for example donkey anti-mouse IgG-AF488+ donkey anti-rabbit IgG-AF594) at room temperature for 1 hour, then washed with PBS 3×5 min, and the sections were then mounted with ProLong Gold antifade reagent with DAPI (Invitrogen, Carlsbad, Calif.). The sections were viewed under a Olympus BX51 System fluorescence microscope (Olympus Corporation, Tokyo, Japan). For HLA-2A immunohistochemistry of SK-MEL-5 melanoma xenografts to chimeric mouse/human skin, frozen sections were incubated with 5 μg/ml mouse anti-human HLA-2A Ab (BD Pharmingen, San Jose, Calif.) at 4° C. overnight. After washing out unbound primary Ab with phosphate buffered saline (PBS), sections were incubated with 1:200 peroxidase-conjugated horse anti-mouse IgG Ab (Vector Laboratories, Burlingame, Calif.) at room temperature for 30 min. Unbound secondary Ab was washed out with PBS. Color was developed using the NovRed peroxidase substrate kit (Vector Laboratories) and sections were counterstained with hematoxylin Gill's No.1 (Fisher Scientific, Pittsburgh, Pa.).

In Situ Hybridization.

RNA probes were prepared as follows: PCR-derived RNA probe templates were synthesized by introducing the T7 promoter into the antisense strand and the SP6 promoter into the sense strand. The primer pair, AB5T7AS (5′-TAATACGACTCACTATAGGGATGTCTGGCTTTTTCCCTTCTTGAC-3′) (SEQ ID NO:15) and AB5SP6S (5′-GATTTAGGTGACACTATAGAAATTCAAGCTGGACGAATGACCCCA-3′) (SEQ ID NO:16), was used to generate the DNA template for antisense and sense RNA probes spanning 200 base pairs of human ABCB5 cDNA. This sequence encodes ABCB5 amino acids 499-564 (GI:34539755). The primer pair CD133T7AS (5′-TAATACGACTCACTATAGGGAGCAGCCCCAGGACACAGCATA-3′) (SEQ ID NO:17) and CD133SP6S (5′-GATTTAGGTGACACTATAGAGACCCAAGACTCCCATAAAGC-3′) (SEQ ID NO:18) was used to generate the DNA template for antisense and sense RNA probes spanning 200 base pairs of human CD133 cDNA, wherein this sequence encodes CD133 amino acid 42-108 (GI: 5174386). The sequence specificities for ABCB5 and CD133 were confirmed using the Genbank database BLAST program. The RNA probes were labeled with digoxigenin (DIG) using the DIG RNA labeling kit (Roche Applied Science, Indianapolis, Ind.). For in situ hybridization, 8 μM frozen tissue sections were baked at 50° C. for 15 min, then fixed in 4% paraformaldehyde at room temperature (RT) for 20 min. The sections were treated with 1 μg/ml proteinase K/PBS at 37° C. for 20 min and inactivated proteinase K with 0.2% glucine/PBS at RT for 5 min. Upon washes with PBS 2×2 min, the tissue sections were fixed in 4% paraformadehyde at RT for 15 min, washed with PBS 2×5 min, and then treated with 0.25% acetic anhydride/0.1M triethanolamine at RT for 10 min. The tissue sections were placed in 2×SSC and then hybridized with 500 ng/ml antisense or sense probe in hybridization buffer (0.3M NaCl, 10 mM Tris-HCl pH 7.6, 5 mM EDTA, 1 × Denharts, 50% formamide, 100 μg/ml tRNA and 10% dectran sulphate) at 42° C. overnight. Post hybridization sections were treated with 0.2×SSC at 55° C. for 2×20 min, 20 □g/ml RNaseA in 0.5M NaCl, 10 mM Tris-HCl pH 7.5 at 37° C. for 30 min, and 0.2×SSC at 55° C. for 20 min. The hybridized probes were immunodetected using the DIG detection kit (Roche) and the Tyramide Signal Amplification (TSA) kit (PerkinElmer, Boston, Mass.) as follows: 1×DIG block buffer for 30 min, 1:100 anti-DIG Ab peroxidase conjugate at RT for 1 hour, 1×DIG wash 3×5 min, TSA reagent 10 min at RT, PBS 2×5 min, 1:100 streptavidin-horseradish peroxidase 30 min at RT, PBS 3×5 min. The labeling was visualized with NovaRed substrate (Vector Laboratories).

Animals.

BALB/c nude mice and NOD/SCID mice were purchased from The Jackson Laboratory (Bar Harbor, Me.). SCID mice (C.B-17) and BALB/c Rag2^(−/−) mice were purchased from Taconic (Germantown, N.Y.). The animals were housed in autoclaved microisolator cages and were fed sterilized food and water. Mice were maintained in accordance with the institutional guidelines of Children's Hospital Boston and Harvard Medical School and experiments were performed according to approved experimental protocols.

Human to Mouse Melanoma Xenotransplantation and Human to Chimeric Mouse/Human Skin Melanoma Xenotransplantation.

Human to mouse melanoma xenografts were established by subcutaneous injection of human G3361, A375, SK-MEL-5 or clinical patient-derived human melanoma cells in BALB/c nude or NOD/SCID mice as described previously³. For human to chimeric mouse/human skin melanoma xenotransplantation, single donor-derived split human skin was obtained in accordance with the Partners HealthCare Research Management Institutional Review Board by cutting abdominal skin with a 0.016-inch gauge dermatome. Human skin was subsequently xenografted onto immunodeficient Rag2^(−/−) mice as described previously¹³, under a protocol approved by the institutional animal committee. Briefly, two circular graft beds, each, 1.5 cm² were prepared on bilateral dorsa of 4-8 week old Rag2^(−/−) micetreated with antibiotics (1 tablet of additional food per week containing Amoxicillin (3 mg), Flagyl (0.69 mg) and Bismuth (0.185 mg)) to prevent Helicobacter pylorii infection. Human donor skin was trimmed to conform to the bed and held in place with staples until 10 days following surgery. Unsegregated or ABCB5⁺-depleted A375, MUM-2B or MUM-2C melanoma cells (2×10⁶ in 20 μl PBS) were intradermally microinjected into grafts after 6 weeks stabilization. All skin grafts were harvested in their entirety 3 weeks after tumour cell inoculation, fixed in formalin, serially sectioned and stained with H&E using standard methods for histological analysis of tumour formation. Sections representing maximum cross-sectional tumour area and thus best approximating the size of the generally spherical to ovoid tumour nodules were evaluated. Tumour volume (TV) was histologically determined and calculated as described³. Statistically significant differences in histological tumour formation were assessed using the Fisher's Exact test. Differences in tumour volume were statistically compared using the nonparametric Mann-Whitney Test, with a two-sided P value of P<0.05 considered significant.

Stable Green Fluorescence Protein (GFP)-Transfected Melanoma Xenografts to Human-SCID Chimeras.

Recombinant lentiviral vectors harboring GFP cDNA were obtained from Dr. M. Herlyn at the Wistar Institute and used to infect human A375 melanoma cells by lentiviral gene transfer. Two days after infection, cells were selected with puromycin (1 μg/ml) for a period of 7 days. Transgene expression was verified by fluorescence microscopy and flow cytometry. Melanoma xenografts were generated in human-SCID chimeras according to the protocol previously described¹³. SCID mice (C.B-17) between 4-6 weeks of age were purchased from Taconic (Germantown, N.Y.). Mice were anesthetized and prepared for transplantation by shaving the hair from a 2 cm² area on the dorsal torso followed by removal of full thickness skin down to the fascia. Full thickness human foreskin grafts of the same size were placed onto the wound beds. The skin grafts were then covered by Vaseline-saturated gauze and secured with band aids and 3M sports tapes. After 10 days, the dressings were removed and the mice allowed to recover for approximately 4-5 weeks before melanoma inoculation. GFP-labeled A375 melanoma cells were harvested and suspended in PBS at a density of 10⁸ cells/ml. One hundred μl each of cell suspension were injected intradermally into the human skin grafts. The tumour xenografts were then harvested in 3 weeks or when the tumour reaches 1 cm³ in size, and processed for frozen section. For double immunofluorescence, frozen sections (5 μm thick) of melanoma xenografts were fixed in 4% paraformaldehyde, blocked with donkey serum, and incubated sequentially with anti-CD144 (Cell Signaling, Danvers, Mass.), Texas red-conjugated donkey anti-rabbit (Invitrogen, Carlsbad, Calif.), anti-GFP (Novus Biologicals, Littleton, Colo.), and FITC-conjugated donkey anti-goat Abs (Jackson ImmunoResearch, West Grove, Pa.). After washing in PBS, the sections were coverslipped using an antiquench mountant containing DAPI (VectaShield, Vector Laboratories, Burlingame, Calif.). Irrelevant isotype-matched primary Abs were included as controls.

Example 2

The mechanisms through which ABCB5⁺ MMIC or CSC in other cancers trigger and promote neoplastic progression are currently unknown. We hypothesized that ABCB5⁺ MMIC possess vasculogenic differentiation plasticity and selectively drive melanoma growth through a specific role in providing nutritional support to growing tumours based on preferential co-expression in vivo of the vasculogenic differentiation markers CD144 (VE-cadherin) and TIE-1³ by the ABCB5⁺ tumourigenic minority population.

To further characterize the repertoire of genes differentially expressed in MMIC compared to tumour bulk populations, we first performed microarray analyses on purified ABCB5⁺ (n=5) and ABCB5⁻ (n=5) cell subsets derived from the established human melanoma cell lines G3361 and A375 and from three separate patient-derived melanoma specimens, all previously characterized in our laboratory with regard to ABCB5 expression and MMIC phenotype in human melanoma xenotransplantation assays³. Using this approach¹⁰, 399 genes were identified that were differentially expressed (P<0.05) between ABCB5⁺ MMIC and ABCB5⁻ melanoma bulk populations (Table 5), in addition to ABCB5 shown overexpressed in ABCB5⁺ purified populations by real-time PCR (P<0.05). One identified functional gene network, validated by PCR-based gene expression analyses in ABCB5⁺ melanoma cell subsets, showed key molecules of vasculogenesis (the ability to differentiate along endothelial lines), FLT1 (VEGFR-1) and PTK2 (FAK), and of angiogenesis (the ability to induce ingrowth and proliferation of mature stromal blood vessels), FLT1 (VEGFR-1), PTK2 (FAK), MET (HGFR), NRP2, and ETS1, to be specifically overexpressed in ABCB5⁺ MMIC (FIG. 1a,b ).

Another set of genes differentially expressed in ABCB+ melanoma stem cells vs. ABCB5-melanoma bulk population cells was identified using RT-PCR. The data is shown in Table 6. The fold-expression levels are shown in the 7^(th) column and can be compared to the control values shown in the last few rows of the table. A positive value indicates that the gene had higher expression levels in ABCB5+ cells and a negative value indicates that the gene had higher expression levels in ABCB5− cells. Some of the genes exhibited a greater than 100-fold and some even greater 1000-fold increase in expression in ABCB5+ versus ABCB5− cells. The highly expressed genes include factors that are likely secreted by the stem cells which may act on cells in a tumor either in an autocrine fashion on tumor stem cells, or in a paracrine fashion also on bulk population cancer cells. Appropriate therapies can be designed to treat cancers by inhibiting the expression or activity of such factors.

Preferential expression of VEGFR-1 by ABCB5⁺ MMIC vs. ABCB5⁻ subpopulations was also demonstrated by dual-color flow cytometry at the protein level (15.6±5.3% vs. 4.4±2.0% of cells, respectively, mean±s.e.m., n=6, P<0.05) (FIG. 1c ). To determine whether VEGF/VEGFR-1 interaction in MMIC influenced expression of the vasculogenic differentiation marker CD144, we evaluated functionally the effects of VEGF signaling in purified ABCB5⁺ MMIC or ABCB5⁻ melanoma subpopulations. VEGF (100 ng/ml¹¹) selectively induced expression of CD144 at high levels in VEGFR-1-expressing ABCB5⁺ but not VEGFR-1-negative ABCB5⁻ melanoma cells, to 36.2±5.7% vs. 4.8±2.7% of cells (mean±s.e.m., n=3), respectively (P<0.01) (FIG. 1d ). Preincubation with a blocking monoclonal antibody (mAb) to VEGFR-1 abrogated the ability of VEGF to induce CD144 expression in human melanoma cells (0.0±0.0% in VEGFR-1 mAb-treated vs. 64±1% or 57±3% in untreated or isotype control mAb-treated cultures, respectively, mean±s.e.m., n=3, P<0.01) (FIG. 1e ). Moreover, VEGFR-1 mAb strongly inhibited VEGF-induced multicellular capillary-like tube formation by human melanoma cells in established in vitro vasculogenic differentiation assays¹¹, with significantly reduced numbers of tubes formed/microscopy field (6.7±0.9 in VEGFR-1 mAb-treated vs. 99.0±24.0 or 76.7±3.3% in untreated or isotype control mAb-treated cultures, respectively, mean±s.e.m., n=3, P<0.05), and significantly lower average tube length (33.2±4.5 μm in VEGFR-1 mAb-treated vs. 92.1±1.6 μm or 86.5±1.7 μm in untreated or isotype control mAb-treated cultures, respectively, mean±s.e.m., n=3, P<0.001) (FIG. 1f ). In contrast, both ABCB5⁺ MMIC and ABCB5⁻ melanoma bulk population exhibited similar adipogenic and osteogenic differentiation capacity previously detected in human melanoma cells¹² (adipogenesis: 100.0±0.0% vs. 93.2±6.9% of cells Oil Red-positive, respectively; mean±s.e.m., n=3, NS; osteogenesis: 90.8±9.2% vs. 98.3±1.7% of cells Alizarin Red-positive, respectively; mean±s.e.m., n=3, NS) (FIG. 1g,h ), and neither ABCB5⁺ MMIC nor ABCB5⁻ melanoma bulk population exhibited capacity for myogenic differentiation¹⁰ (0.0±0.0% vs. 0.0±0.0% of cells myogenin-positive, respectively; mean±s.e.m., n=3, NS) (FIG. 1h ). The selective in vitro vasculogenic differentiation capacity of ABCB5⁺ MMIC in response to VEGF/VEGFR-1 signaling indicated a potential role of this CSC subset in tumour vasculogenesis.

TABLE 5 Differentially expressed genes between ABCB5⁺ MMIC and ABCB5⁻ melanoma bulk populations (P < 0.05). Molecules ID Fold Change AABHD7 239579_at 0.661 ACBD6 225317_at 0.83 AK3 224655_at 0.845 AKAP9 215483_at 2.168 AKR1CL2 1559982_s_at 1.732 AMZ2 227567_at 1.377 ANAPC5 235926_at 2.631 ANK2 202921_s_at 4.162 ANKH 229176_at 0.776 ANKRD28 241063_at 2.297 ANKRD44 226641_at 1.218 ANKRD52 228257_at 0.762 ANXA4 201302_at 0.83 AOC3 204894_s_at 1.894 APBB2 40148_at 1.139 ARS2 201679_at 1.307 ASCC3L1 214982_at 3.009 (includes EG:23020) ASPM 232238_at 1.411 ATAD2 235266_at 1.304 ATP5I 207335_x_at 0.737 ATXN2L 207798_s_at 1.656 BARD1 205345_at 1.559 BAT3 230513_at 0.697 BCL9L 227616_at 1.291 BDP1 224227_s_at 1.632 BLID 239672_at 1.91 BRI3 223376_s_at 0.792 BUB1 216277_at 1.856 (includes EG:699) BUB1 233445_at 3.209 (includes EG:699) C10ORF18 244165_at 2.046 C12ORF45 226349_at 0.688 C12ORF48 220060_s_at 1.216 C12ORF51 230216_at 2.874 C12ORF51 1557529_at 3.632 C14ORF135 1563259_at 1.353 C14ORF156 221434_s_at 0.867 C16ORF63 225087_at 0.872 C18ORF10 213617_s_at 0.754 C18ORF10 212055_at 0.737 C19ORF42 219097_x_at 0.813 C20ORF4 234654_at 1.731 C22ORF28 200042_at 0.829 C22ORF30 216555_at 1.521 C2ORF30 224630_at 0.851 C5ORF24 229098_s_at 1.531 C9ORF78 218116_at 0.789 C9ORF85 244160_at 1.52 CABIN1 1557581_x_at 3.052 CAMK2D 225019_at 0.823 CAMK2D 228555_at 0.758 CANX 238034_at 0.8 CAPZB 201949_x_at 0.764 CASC5 228323_at 1.144 CBS 240517_at 1.818 CCDC127 226515_at 0.835 CCDC14 240884_at 1.771 CCDC52 234995_at 1.166 CCDC57 214818_at 1.703 CCDC73 239848_at 1.294 CCDC93 219774_at 1.208 CDC14B 234605_at 2.512 CDC16 242359_at 6.261 CENPJ 234023_s_at 1.22 CENPJ 220885_s_at 1.64 CEP27 228744_at 0.651 CEP55 218542_at 1.096 CGGBP1 224600_at 0.913 CHD2 244443_at 1.757 CHD8 212571_at 1.27 CLN8 229958_at 1.344 CNIH3 232758_s_at 1.451 COBRA1 1556434_at 1.985 COIL 203653_s_at 1.259 COL4A2 211966_at 0.729 COQ4 218328_at 1.328 CPEB2 226939_at 1.251 CPNE3 202119_s_at 0.833 CREB1 204313_s_at 0.791 CREB3L2 237952_at 2.013 CRIPAK 228318_s_at 1.486 CROP 242389_at 2.121 CSE1L 201112_s_at 0.911 CSE1L 210766_s_at 0.885 CUL4A 232466_at 2.607 CYB5R3 1554574_a_at 0.793 DARS 201624_at 0.928 DCLRE1C 242927_at 1.187 DCUN1D2 240478_at 1.76 DDX17 213998_s_at 1.528 DDX52 212834_at 0.771 DEGS1 209250_at 0.804 DEPDC1 232278_s_at 1.119 DHX40 218277_s_at 0.812 DNAJC21 230893_at 0.829 DNM1L 236032_at 1.503 DTX3 49051_g_at 1.32 ECHDC1 233124_s_at 0.943 EIF2S1 201142_at 0.717 EIF2S1 201144_s_at 0.824 EIF4G3 201935_s_at 1.174 ELOVL2 213712_at 0.699 EMP2 225079_at 0.781 ENAH 222433_at 0.783 ENDOD1 212573_at 0.775 ENTPD5 231676_s_at 0.867 ERBB3 1563253_s_at 0.691 ERRFI1 224657_at 0.881 ETS1 241435_at 1.797 EWSR1 229966_at 1.686 EXT1 242126_at 2.116 FAM62C 239770_at 1.551 FAM98A 212333_at 0.767 FHL3 218818_at 0.546 FLJ10357 241627_x_at 2.31 FLJ31306 239432_at 1.753 FLT1 232809_s_at 1.861 FOXN3 218031_s_at 0.721 FUBP1 240307_at 2.087 GABARAPL2 209046_s_at 0.863 GABPA 243498_at 2.03 GALNT1 201722_s_at 0.926 GBF1 233114_at 2.03 GGT1 211417_x_at 1.555 GHITM 1554510_s_at 0.764 GMFB 202544_at 0.904 GNPDA1 202382_s_at 0.787 GOLGA8A 213650_at 2.289 GPD2 243598_at 2.13 GPR107 211979_at 0.843 GPR135 241085_at 1.851 HDAC3 240482_at 2.062 HEATR2 241352_at 0.784 HECW1 237295_at 11.843 HELLS 242890_at 1.359 HERC5 219863_at 1.156 HIAT1 225222_at 0.832 HNRNPC 235500_at 1.769 HNRPD 235999_at 1.92 HNRPD 241702_at 1.962 HNRPH1 213472_at 2.332 HOXA2 228642_at 1.44 HOXB9 216417_x_at 0.766 HOXD3 206601_s_at 1.897 HPS1 239382_at 1.749 HSD17B1 228595_at 0.753 HSDL2 209513_s_at 0.803 HSPA4L 205543_at 0.786 HUWE1 214673_s_at 1.858 IDS 1559136_s_at 2.001 IFNGR1 242903_at 2.171 IGHMBP2 215980_s_at 0.893 IL13RA1 201887_at 0.775 INSIG2 209566_at 0.872 IPO7 200993_at 0.875 IPW 213447_at 1.399 IRS2 236338_at 2.162 JARID1A 226367_at 1.192 JARID2 232835_at 2.139 KIAA0841 36888_at 1.389 KIAA0907 230028_at 1.83 KIAA1267 224489_at 1.355 KIAA1618 231956_at 2.27 KIAA1737 225623_at 0.837 KIAA2013 1555933_at 2.18 KIDINS220 1557246_at 2.97 KPNA6 226976_at 0.814 KRTAP19-1 1556410_a_at 2.07 KSR2 230551_at 3.211 LBA1 213261_at 1.225 LIMS1 212687_at 0.822 LOC126917 225615_at 0.819 LOC137886 212934_at 0.886 LOC145757 1558649_at 2.779 LOC145786 229178_at 1.907 LOC146325 1553826_a_at 3.943 LOC203547 225556_at 0.802 LOC219731 1557208_at 0.419 LOC254128 1557059_at 2.164 LOC283888 1559443_s_at 2.56 LOC285147 236166_at 2.377 LOC338799 226369_at 1.137 LOC388135 230475_at 1.979 LOC388969 232145_at 1.555 LOC389203 225014_at 0.79 LOC641298 208118_x_at 1.419 LOC645166 228158_at 0.823 LOC645513 239556_at 2.24 LOC729397 236899_at 2.231 LRCH3 229387_at 1.793 LRRFIP1 239379_at 1.796 MAEA 207922_s_at 0.765 MALAT1 224568_x_at 1.699 MALAT1 223940_x_at 1.659 MAP1LC3B 208785_s_at 0.808 MAP2K4 203266_s_at 0.881 MAP3K15 200979_at 0.741 6-Mar 201737_s_at 1.219 MBNL1 201152_s_at 0.867 MDM4 235589_s_at 1.629 MECR 218664_at 0.832 MED19 226300_at 0.782 MEF2C 236395_at 2.104 MET 213816_s_at 1.283 MIA3 1569057_s_at 0.759 MLL 212079_s_at 1.599 MOBKL1B 214812_s_at 0.762 MRPL42 217919_s_at 0.866 (includes EG:28977) MRPL51 224334_s_at 0.846 MTERFD3 225341_at 1.422 MTUS1 239576_at 1.975 MYO10 243159_x_at 2.528 MYO10 244350_at 1.677 N4BP2L1 213375_s_at 2.01 N4BP2L2 235547_at 1.631 N4BP2L2 242576_x_at 2.349 NAALAD2 1554506_x_at 0.464 NANP 228073_at 0.817 NAPA 239362_at 1.624 NAPE-PLD 242635_s_at 1.216 NARG1 1556381_at 2.827 NAT8B 206964_at 2.513 NBPF16 201104_x_at 1.411 NBR1 1568856_at 1.957 NCKAP1L 209734_at 2.071 NDFIP1 217800_s_at 0.815 NDUFAF2 228355_s_at 0.722 NDUFB6 203613_s_at 0.712 NEK1 213328_at 1.381 NFATC2IP 217527_s_at 1.272 NPAS2 1557690_x_at 1.76 NPTN 228723_at 2.086 NRP2 210841_s_at 1.106 NUCB2 203675_at 0.812 NUDT4 212183_at 0.685 NUPL1 241425_at 2.179 OCIAD1 235537_at 1.794 ORMDL1 223187_s_at 1.171 OSBPL5 233734_s_at 1.261 OSGEP 242930_at 1.541 PABPN1 213046_at 2.228 PAK1 226507_at 0.869 PAPD4 222282_at 3.39 PDE4B 215671_at 3.457 PDHB 211023_at 0.827 PDHB 208911_s_at 0.807 PDK1 239798_at 1.654 PDLIM5 212412_at 0.752 PDSS1 236298_at 1.64 PDXDC1 1560014_s_at 2.105 PGRMC2 213227_at 0.686 PHC1 218338_at 1.123 PHF20L1 219606_at 2.3 PIGY 224660_at 0.793 (includes EG:84992) PIP5K3 1557719_at 2.227 PITPNA 201190_s_at 0.863 PMP22 210139_s_at 0.865 PMS2L3 214473_x_at 1.159 POFUT2 207448_at 1.759 POLR2J2 1552622_s_at 1.828 POLR2J2 1552621_at 1.652 POP4 202868_s_at 0.847 PPP1R3D 204554_at 0.805 PPP1R7 201213_at 0.698 PPP3CA 202457_s_at 0.867 PRO1073 228582_x_at 1.607 PRPF38B 230270_at 1.888 PSEN1 242875_at 1.851 PSMA2 201316_at 0.839 PSMA3 201532_at 0.798 PTK2 234211_at 2.539 PTPMT1 229535_at 0.769 RAB11FIP3 228613_at 2.546 RAB11FIP3 216043_x_at 0.551 RAB14 200927_s_at 0.772 RAB1A 213440_at 0.81 RAD54L 204558_at 1.483 RADIL 223693_s_at 2.126 RBM25 1557081_at 1.57 RBM26 229433_at 1.43 RBM4 213718_at 1.53 RBM5 209936_at 2.249 RFT1 240281_at 1.426 RHOA 240337_at 2.143 RHOBTB2 1556645_s_at 1.538 RLBP1L1 224996_at 0.835 RNF43 228826_at 1.401 RP11-139H14.4 1569124_at 11.472 RPE 221770_at 0.766 RPE 225039_at 0.787 RPL7L1 225515_s_at 0.899 RUNX3 204198_s_at 1.233 SDAD1 242190_at 3.009 SDCCAG8 243963_at 2.67 SEC16B 1552880_at 1.877 SEPHS1 208940_at 0.875 11-Sep 201307_at 0.784 SF1 210172_at 2.452 SF3B1 201070_x_at 1.35 SF3B1 214305_s_at 1.359 SFRS15 222311_s_at 1.818 SFRS15 243759_at 2.028 SGCA 1562729_at 2.395 SGOL2 235425_at 1.591 SH2B3 203320_at 0.806 SKP1 200718_s_at 0.898 SLC16A1 202235_at 0.83 SLC20A1 230494_at 1.884 SLC2A11 232167_at 1.529 SLC2A8 239426_at 2.012 SLC30A9 237051_at 2.063 SMA4 238446_at 2.035 SMC6 218781_at 1.203 SMYD2 212922_s_at 0.867 SNORA28 241843_at 1.628 SNRPA1 242146_at 3.54 SON 201085_s_at 1.144 SPOPL 225659_at 0.828 SQLE 213577_at 1.502 SRP72 208801_at 0.751 SRP72 208803_s_at 0.766 SRPRB 218140_x_at 0.767 STK36 234005_x_at 1.335 STK36 231806_s_at 1.362 STRAP 1558002_at 2.189 STX11 235670_at 0.778 STX8 204690_at 0.819 SUPT7L 201838_s_at 0.865 SVIL 215279_at 2.228 SYNE2 202761_s_at 1.356 TAF15 227891_s_at 1.971 TAF1B 239046_at 1.468 TAOK3 220761_s_at 1.195 TBC1D5 201814_at 0.782 TBC1D8 221592_at 1.246 TBC1D8 204526_s_at 1.373 TBXA2R 207554_x_at 0.877 TBXA2R 336_at 0.73 TCAG7.907 238678_at 1.546 TCOF1 202385_s_at 1.169 (includes EG:6949) TFB1M 228075_x_at 0.87 THRAP3 217847_s_at 1.464 TIMM23 218119_at 0.723 TM6SF1 1558102_at 0.704 TMEM126B 221622_s_at 0.843 TMEM165 1560622_at 1.756 TMEM30A 232591_s_at 0.771 TNFAIP1 201207_at 0.88 TNPO1 1556116_s_at 1.739 TNRC6A 234734_s_at 1.268 TOX4 201685_s_at 0.73 TPM4 235094_at 2.079 TRAPPC2 219351_at 0.821 TRAPPC2L 218354_at 0.837 TRIM33 239716_at 2.496 TRIM46 238147_at 1.96 TRIO 240773_at 2.607 TRNT1 243236_at 2.295 TRPV1 1556229_at 2.636 TSPAN31 203227_s_at 0.744 TTC26 233999_s_at 1.184 TTC3 208664_s_at 1.396 TTC9C 1569189_at 1.55 TTLL4 1557611_at 2.092 TXNDC12 223017_at 0.849 TXNL1 243664_at 1.98 UBE2E3 210024_s_at 0.758 UBE3C 1560739_a_at 0.815 UBXD7 212840_at 0.754 UGT1A6 206094_x_at 3.86 UNK 1562434_at 1.637 UQCC 229672_at 1.451 USP36 224979_s_at 1.393 USP8 229501_s_at 0.808 VPS37B 236889_at 2.85 VTI1B 209452_s_at 0.821 WDR41 218055_s_at 0.789 WDR68 233782_at 1.924 WFS1 1555270_a_at 1.315 WIPF2 216006_at 2.916 WTAP 1560274_at 1.747 XRCC5 232633_at 2.106 YY1 224711_at 0.821 ZFHX3 215828_at 1.737 ZFR 238970_at 2.655 ZFX 207920_x_at 1.625 ZMYND8 209049_s_at 1.102 ZNF154 242170_at 2.667 ZNF224 216983_s_at 2.986 ZNF226 219603_s_at 1.332 ZNF251 226754_at 1.313 ZNF292 236435_at 3.201 ZNF326 241720_at 1.418 ZNF337 1565614_at 2.096 ZNF536 233890_at 3.303 ZNF567 242429_at 2.103 ZNF618 226590_at 0.75 ZNF668 219047_s_at 0.691 ZNF800 227101_at 1.484 ZUFSP 228330_at 1.205

TABLE 6 Differentially expressed genes between ABCB5⁺ and ABCB5⁻ cells as detected by RT-PCR. PCR Array Catalog #: PAHS-024 ABCB5+/ ABCB5− Fold Position Unigene Refseq Symbol Description Gname change A01 Hs.525622 NM_005163 AKT1 V-akt murine thymoma AKT/PKB 1.2687 viral oncogene homolog 1 A02 Hs.369675 NM_001146 ANGPT1 Angiopoietin 1 AGP1/AGPT 1.2953 A03 Hs.583870 NM_001147 ANGPT2 Angiopoietin 2 AGPT2/ANG2 2.7007 A04 Hs.209153 NM_014495 ANGPTL3 Angiopoietin-like 3 ANGPT5 3.0596 A05 Hs.9613 NM_001039667 ANGPTL4 Angiopoietin-like 4 ANGPTL2/ARP4 1.6974 A06 Hs.1239 NM_001150 ANPEP Alanyl (membrane) APN/CD13 1.3597 aminopeptidase (aminopeptidase N, aminopeptidase M, microsomal aminopeptidase, CD13, p150) A07 Hs.194654 NM_001702 BAI1 Brain-specific FLJ41988 3.0596 angiogenesis inhibitor 1 A08 Hs.54460 NM_002986 CCL11 Chemokine (C-C motif) SCYA11 1.8834 ligand 11 A09 Hs.303649 NM_002982 CCL2 Chemokine (C-C motif) GDCF-2/ 2.0326 ligand 2 GDCF-2HC11 A10 Hs.76206 NM_001795 CDH5 Cadherin 5, type 2, VE- 7B4/CD144 3.0596 cadherin (vascular epithelium) A11 Hs.517356 NM_030582 COL18A1 Collagen, type XVIII, KNO 1.9634 alpha 1 A12 Hs.570065 NM_000091 COL4A3 Collagen, type IV, alpha TUMSTATIN 2.1634 3 (Goodpasture antigen) B01 Hs.789 NM_001511 CXCL1 Chemokine (C-X-C FSP/GRO1 1.2086 motif) ligand 1 (melanoma growth stimulating activity, alpha) B02 Hs.632586 NM_001565 CXCL10 Chemokine (C-X-C C7/IFI10 −2.1987 motif) ligand 10 B03 Hs.89690 NM_002090 CXCL3 Chemokine (C-X-C CINC-2b/ 2.061 motif) ligand 3 GRO3 B04 Hs.89714 NM_002994 CXCL5 Chemokine (C-X-C ENA-78/ 1.8834 motif) ligand 5 SCYB5 B05 Hs.164021 NM_002993 CXCL6 Chemokine (C-X-C CKA-3/ 2.1936 motif) ligand 6 GCP-2 (granulocyte chemotactic protein 2) B06 Hs.77367 NM_002416 CXCL9 Chemokine (C-X-C CMK/Humig −1.1225 motif) ligand 9 B07 Hs.592212 NM_001953 TYMP Thymidine ECGF1/ 1.5837 phosphorylase MNGIE B08 Hs.154210 NM_001400 EDG1 Endothelial CHEDG1/ 1.0377 differentiation, D1S3362 sphingolipid G-protein- coupled receptor, 1 B09 Hs.516664 NM_182685 EFNA1 Ephrin-A1 B61/ECKLG 1.4573 B10 Hs.516656 NM_004952 EFNA3 Ephrin-A3 EFL2/EPLG3 1.3692 B11 Hs.149239 NM_004093 EFNB2 Ephrin-B2 EPLG5/HTKL 1.1355 B12 Hs.419815 NM_001963 EGF Epidermal growth factor HOMG4/URG 187.8365 (beta-urogastrone) C01 Hs.76753 NM_000118 ENG Endoglin (Osler-Rendu- CD105/END 1.1514 Weber syndrome 1) C02 Hs.437008 NM_004444 EPHB4 EPH receptor B4 HTK/MYK1 1.3692 C03 Hs.115263 NM_001432 EREG Epiregulin ER 1.8834 C04 Hs.483635 NM_000800 FGF1 Fibroblast growth factor AFGF/ECGF 1.5511 1 (acidic) C05 Hs.284244 NM_002006 FGF2 Fibroblast growth factor BFGF/FGFB 1.1355 2 (basic) C06 Hs.1420 NM_000142 FGFR3 Fibroblast growth factor ACH/CD333 1.7092 receptor 3 (achondroplasia, thanatophoric dwarfism) C07 Hs.11392 NM_004469 FIGF C-fos induced growth VEGF-D/VEGFD 3.5884 factor (vascular endothelial growth factor D) C08 Hs.654360 NM_002019 FLT1 Fms-related tyrosine FLT/VEGFR1 2.4172 kinase 1 (vascular endothelial growth factor/vascular permeability factor receptor) C09 Hs.388245 NM_021973 HAND2 Heart and neural crest DHAND2/Hed 2.0186 derivatives expressed 2 C10 Hs.396530 NM_000601 HGF Hepatocyte growth factor F-TCF/HGFB 4.542 (hepapoietin A; scatter factor) C11 Hs.654600 NM_001530 HIF1A Hypoxia-inducible factor HIF-1alpha/ −1.0918 1, alpha subunit (basic HIF1 helix-loop-helix transcription factor) C12 Hs.44227 NM_006665 HPSE Heparanase HPA/HPR1 286.6871 D01 Hs.504609 NM_002165 ID1 Inhibitor of DNA binding ID -1.0329 1, dominant negative helix-loop-helix protein D02 Hs.76884 NM_002167 ID3 Inhibitor of DNA binding HEIR-1 −1.3535 3, dominant negative helix-loop-helix protein D03 Hs.37026 NM_024013 IFNA1 Interferon, alpha 1 IFL/IFN 1.8834 D04 Hs.93177 NM_002176 IFNB1 Interferon, beta 1, IFB/IFF 1.8834 fibroblast D05 Hs.856 NM_000619 IFNG Interferon, gamma IFG/IFI 1.8834 D06 Hs.160562 NM_000618 IGF1 Insulin-like growth factor IGFI 4.7022 1 (somatomedin C) D07 Hs.126256 NM_000576 IL1B Interleukin 1, beta IL-1/IL1-BETA 2.0898 D08 Hs.654458 NM_000600 IL6 Interleukin 6 (interferon, BSF2/HGF 1.7331 beta 2) D09 Hs.624 NM_000584 IL8 Interleukin 8 3-10C/AMCF-I 1.1674 D10 Hs.436873 NM_002210 ITGAV Integrin, alpha V CD51/DKFZ 1.217 (vitronectin receptor, p686A08142 alpha polypeptide, antigen CD51) D11 Hs.218040 NM_000212 ITGB3 Integrin, beta 3 (platelet CD61/GP3A −1.0619 glycoprotein IIIa, antigen CD61) D12 Hs.224012 NM_000214 JAG1 Jagged 1 (Alagille AGS/AHD 1566.5046 syndrome) E01 Hs.479756 NM_002253 KDR Kinase insert domain CD309/FLK1 1.234 receptor (a type III receptor tyrosine kinase) E02 Hs.473256 NM_005560 LAMA5 Laminin, alpha 5 KIAA1907 3.8727 E03 Hs.421391 NM_007015 LECT1 Leukocyte cell derived BRICD3/ 1.8834 chemotaxin 1 CHM-I E04 Hs.194236 NM_000230 LEP Leptin OB/OBS 2.1485 E05 Hs.82045 NM_002391 MDK Midkine (neurite growth- MK/NEGF2 1.4573 promoting factor 2) E06 Hs.513617 NM_004530 MMP2 Matrix metallopeptidase CLG4/CLG4A 1.674 2 (gelatinase A, 72 kDa gelatinase, 72 kDa type IV collagenase) E07 Hs.297413 NM_004994 MMP9 Matrix metallopeptidase CLG4B/GELB 1.9097 9 (gelatinase B, 92 kDa gelatinase, 92 kDa type IV collagenase) E08 Hs.436100 NM_004557 NOTCH4 Notch homolog 4 INT3/NOTCH3 1.2002 (Drosophila) E09 Hs.131704 NM_003873 NRP1 Neuropilin 1 CD304/ 1.1755 DKFZp686A03134 E10 Hs.471200 NM_003872 NRP2 Neuropilin 2 NP2/NPN2 1.4373 E11 Hs.707991 NM_002607 PDGFA Platelet-derived growth PDGF-A/ 1.2002 factor alpha polypeptide PDGF1 E12 Hs.514412 NM_000442 PECAM1 Platelet/endothelial cell CD31/PECAM-1 11.9037 adhesion molecule (CD31 antigen) F01 Hs.81564 NM_002619 PF4 Platelet factor 4 CXCL4/ 2.9966 (chemokine (C-X-C SCYB4 motif) ligand 4) F02 Hs.252820 NM_002632 PGF Placental growth factor, D12S1900/PGFL −1.1865 vascular endothelial growth factor-related protein F03 Hs.77274 NM_002658 PLAU Plasminogen activator, ATF/UPA 1.6396 urokinase F04 Hs.143436 NM_000301 PLG Plasminogen DKFZp779M0222 1.8834 F05 Hs.125036 NM_020405 PLXDC1 Plexin domain containing DKFZp686F0937/ 3.4184 1 TEM3 F06 Hs.528665 NM_021935 PROK2 Prokineticin 2 BV8/KAL4 1.8446 F07 Hs.201978 NM_000962 PTGS1 Prostaglandin- COX1/COX3 1.2086 endoperoxide synthase 1 (prostaglandin G/H synthase and cyclooxygenase) F08 Hs.532768 NM_002615 SERPINF1 Serpin peptidase EPC-1/PEDF 1.1121 inhibitor, clade F (alpha- 2 antiplasmin, pigment epithelium derived factor), member 1 F09 Hs.68061 NM_021972 SPHK1 Sphingosine kinase 1 SPHK 1.192 F10 Hs.301989 NM_015136 STAB1 Stabilin 1 CLEVER-1/FEEL-1 4.357 F11 Hs.89640 NM_000459 TEK TEK tyrosine kinase, CD202B/TIE-2 −1.2805 endothelial (venous malformations, multiple cutaneous and mucosal) F12 Hs.170009 NM_003236 TGFA Transforming growth TFGA 3549.3357 factor, alpha G01 Hs.645227 NM_000660 TGFB1 Transforming growth CED/DPD1 1.1837 factor, beta 1 G02 Hs.133379 NM_003238 TGFB2 Transforming growth TGF-beta2 1.3787 factor, beta 2 G03 Hs.494622 NM_004612 TGFBR1 Transforming growth AAT5/ACVRLK4 1.7695 factor, beta receptor I (activin A receptor type II-like kinase, 53 kDa) G04 Hs.164226 NM_003246 THBS1 Thrombospondin 1 THBS/TSP −1.0619 G05 Hs.371147 NM_003247 THBS2 Thrombospondin 2 TSP2 −1.203 G06 Hs.522632 NM_003254 TIMP1 TIMP metallopeptidase CLGI/EPA −1.1147 inhibitor 1 G07 Hs.633514 NM_003255 TIMP2 TIMP metallopeptidase CSC-21K 1.2864 inhibitor 2 G08 Hs.701968 NM_000362 TIMP3 TIMP metallopeptidase HSMRK222/ 1.8834 inhibitor 3 (Sorsby K222 fundus dystrophy, pseudoinflammatory) G09 Hs.241570 NM_000594 TNF Tumor necrosis factor DIF/TNF-alpha 4.0652 (TNF superfamily, member 2) G10 Hs.525607 NM_006291 TNFAIP2 Tumor necrosis factor, B94 1.8834 alpha-induced protein 2 G11 Hs.73793 NM_003376 VEGFA Vascular endothelial VEGF/VEGF-A 2.4509 growth factor A G12 Hs.435215 NM_005429 VEGFC Vascular endothelial Flt4-L/VRP 446.7529 growth factor C H01 Hs.534255 NM_004048 B2M Beta-2-microglobulin B2M −1.2983 H02 Hs.412707 NM_000194 HPRT1 Hypoxanthine HGPRT/HPRT −1.2894 phosphoribosyltransferase 1 (Lesch-Nyhan syndrome) H03 Hs.523185 NM_012423 RPL13A Ribosomal protein L13a RPL13A 1.1837 H04 Hs.544577 NM_002046 GAPDH Glyceraldehyde-3- G3PD/GAPD −1.146 phosphate dehydrogenase H05 Hs.520640 NM_001101 ACTB Actin, beta PS1TP5BP1 −1.0329 H06 N/A SA_00105 HGDC Human Genomic DNA HIGX1A 1.8834 Contamination H07 N/A SA_00104 RTC Reverse Transcription RTC 1.7451 Control H08 N/A SA_00104 RTC Reverse Transcription RTC 1.7451 Control H09 N/A SA_00104 RTC Reverse Transcription RTC 1.7695 Control H10 N/A SA_00103 PPC Positive PCR Control PPC 1.8067 H11 N/A SA_00103 PPC Positive PCR Control PPC 1.7818 H12 N/A SA_00103 PPC Positive PCR Control PPC 36695.9527

Example 3

We therefore tested the hypothesis that MMIC, as defined by the novel marker ABCB5³, specifically relate to the phenomenon of vasculogenic mimicry whereby melanoma cells form channels capable of conducting nutrients from peripheral blood and thus serving as surrogates for mature tumour vessels⁴. Because we posited that this phenomenon may be more robust during early stages of tumour formation before cancer angiogenesis fully develops, we evaluated experimentally-induced human-derived melanomas grown as tumour xenografts in the subcutis of immunodeficient mice and in the dermis of human skin xenografted to immunodeficient mice (FIG. 2), the latter a humanized model whereby human melanoma develops in the context of the human stromal microenvironment¹³. While only peripheral tumour vessels expressed the mature endothelial marker, CD31, more interior regions of the melanomas exhibited formation of CD31-negative anastomosing channels with histologic, histochemical (PAS-D and laminin reactivity), and ultrastructural findings consistent with established features of vasculogenic mimicry⁴ (FIG. 2a-d ). By electron microscopy, lumen-like spaces in these regions were lined by basement membrane-like material and viable melanoma cells and contained erythrocytes surrounded by finely granular matrix consistent with plasma, suggesting communication with the systemic circulation⁴. By immunohistochemistry and in situ hybridization, channels expressed ABCB5 protein and mRNA, respectively (FIG. 2f-h ), which also correlated in vitro when assayed across a panel of human melanoma cell lines (FIG. 4), and the architecture of ABCB5⁺ channels in xenografted tumours was identical to that focally detected in patient-derived melanomas (FIG. 2f , inset). An identical pattern was also observed for CD133 mRNA (not illustrated), an additional marker for tumourigenic melanoma cells¹⁴ and melanoma progression¹⁵. Anti-ABCB5 mAb systemically administered in vivo localized to channels, further confirming their systemic perfusion as well as the intimate association of ABCB5⁺ melanoma cells with channel lumens (FIG. 2i ). Double-labeling demonstrated co-localization of the human endothelial markers CD144 and TIE-1 with ABCB5⁺ cells forming channels (FIG. 2j,k ). Tumours initiated by melanoma cell lines expressing the green fluorescence protein (GFP) transgene confirmed the presence of melanoma cells lining channels that co-expressed melanoma-associated GFP and CD144 (FIG. 2e ), as well as human melanoma—but not human xenograft-associated class I major histocompatibility complex (MHC) antigens (not illustrated). These data show that the formation of perfused vessel-like channels in human melanoma is mediated by the ABCB5⁺ MMIC subpopulation found to selectively display gene profiles and differentiation capacity consistent with its participation in tumour vasculogenesis.

Example 4

We next reasoned that if vasculogenic channel formation mediated by ABCB5⁺ MMIC was functionally required for their capacity to efficiently initiate and drive melanoma growth, depletion of MMIC to low levels should inhibit the melanoma-associated vasculogenic response. To evaluate tumourigenesis and vasculogenesis in a bioassay most relevant to human primary melanoma, we again utilized a human skin/murine xenograft model whereby melanomas develop in the relevant dermal microenvironment of human skin and express architectural features and evolutionary growth patterns more akin to naturally occurring lesions¹³. Intradermal orthotopic transplantation of 2×10⁶ unsegregated A375 cutaneous melanoma cells (ABCB5 positivity: 5.2±5.1%; mean±s.e.m., n=9) (FIG. 3a ) or heterotopic transplantation of 2×10⁶ unsegregated uveal melanoma cells previously assayed for vasculogenic differentiation^(4,16) (MUM-2B and MUM-2C, ABCB5 positivity: 2.46±0.46% and 3.81±1.04%, respectively; mean±s.e.m., n=3-4) (FIG. 3a ) to human skin resulted in tumour formation three weeks following microinjections in 14 of 14 recipient skin grafts (A375: n=6, MUM-2B: n=4, MUM-2C: n=4 replicates) when assessed histologically in serial sections of each human skin xenograft in its entirety (FIG. 3b,c ). In contrast, intradermal transplantation of equal numbers of ABCB5⁺-depleted melanoma cells resulted in histologically-assessed tumour formation in only 6 of 14 recipient skin grafts (P<0.002) (FIG. 3b,c ) and histologically-determined mean tumour volumes (TV) were significantly reduced in recipients of ABCB5⁺-depleted vs. unsegregated melanoma inocula (TV=2.8±1.8 mm³ vs. 10.9±6.9 mm³, respectively; mean±s.e.m., P<0.005) (FIG. 3d ). When vasculogenic channel formation within tumours was evaluated using quantitative image analysis technology to assess the pixilated density of laminin immunoreactivity, significantly fewer channels per cross-sectional area were detected in tumours that formed from MMIC-depleted inocula compared to those that originated from unsegregated tumour cell grafts (A375, P<0.0032; MUM-2B, P<0.0005; MUM-2C, P<0.0059) (FIG. 3e,f ). In aggregate, these findings show in relevant xenograft models of early melanoma development the participation of ABCB5⁺ MMIC in the genesis of vasculogenic channels, and the interdependency of MMIC-derived channel formation and tumour growth.

Discovery of MMIC-driven vasculogenesis identifies selective differentiation plasticity as a novel CSC-specific function through which these tumourigenic cancer subpopulations may provide a specific growth advantage to developing tumours. Our finding of a propensity of MMIC to differentiate selectively into cells capable of serving a defined tissue function required for more efficient tumour growth parallels hallmark characteristics of physiological stem cells, which similarly give rise to cell lineages capable of serving specific roles required for maintenance of tissue homeostasis through defined differentiation programs. Importantly, we find that MMIC-dependent tumourigenesis and vasculogenesis are operative not only in human melanoma to murine skin xenotransplantation models but also upon human melanoma to human skin transplantation. Therefore, our results provide initial evidence that the tumour-sustaining role of human CSC identified in xenotransplantation assays does not merely reflect the limited ability of human tumour cells to adapt to growth in a foreign (mouse) milieu, as has been postulated based on the results of murine tumour transplantation experiments utilizing histocompatible murine hosts¹⁷

The now widely-accepted concept of cancer angiogenesis advanced by Folkman in 1971 states that human cancers are critically dependent upon tumour-related blood-vessel growth and development¹⁸. In addition to classical angiogenesis whereby cancer cells, including CSC¹⁹, induce in-growth of mature, CD31-positive vessels from surrounding stroma²⁰, evidence has been generated that cancer cells may also directly form surrogate vessel-like spaces by the process of vasculogenic mimicry whereby aggressive human melanomas develop patterned networks composed of periodic acid-Schiff (PAS)- and laminin-reactive basement membranes and associated perfusable channels formed by tumour cells that express some but not all endothelium-related genes and proteins⁴. The present study identifies the cells and underlying mechanisms responsible for vasculogenic mimicry, and establishes that in addition to self-renewal, MMIC selectively express vasculogenic genes and form channels consistent with the function of promoting nutrition to rapidly growing tumours. Thus, cancer angiogenesis and MMIC-driven vasculogenesis may represent independent yet potentially interrelated mechanisms whereby aggressive and metabolically-active tumours obtain those nutrients requisite for critical stages of growth and evolution. This may be particularly important during tumour initiation and early phases of tumourigenic growth when hypoxia-dependent, mTOR-driven angiogenesis from surrounding stroma has not fully evolved²¹.

Recently, proof-of-principle has been established for the potential therapeutic utility of the CSC concept^(3,22). Therefore, identification of a vasculogenic mechanism whereby MMIC may contribute to tumour growth has potentially important therapeutic implications. Previous studies revealed that normally resistant human melanoma cells are rendered sensitive in vitro to the effects of chemotherapeutic agents by mAb- or siRNA-mediated blockade of ABCB5^(5,6), and that mAb binding to ABCB5 is sufficient to induce an effective anti-melanoma immune response via antibody-dependent cell-mediated cytotoxicity (ADCC) in vivo³. Now, recognition of the role of MMIC in tumour vasculogenesis will also permit development of strategies focused on inhibition of the relevant molecular pathways integral to endothelial-directed CSC plasticity. Moreover, the spatial localization of the MMIC component to channels that communicate with the systemic circulation may render this important determinant of cancer virulence particularly vulnerable to therapeutic targeting.

Example 5: Vasculogenic/Angiogenic Pathways in Human Melanoma

We investigated gene relationships based on Ingenuity Pathway Analysis. We prepared a graphical representation of pathway activation across ABCB5⁺ MMIC. Genes that were overexpressed in ABCB5⁺ relative to ABCB5⁻ human melanoma cells were represented by red nodes (circles) and those expressed at lower levels were represented by black nodes. Black lines were drawn between genes to show known interactions. Known gene functions in vasculogenesis and angiogenesis, and genes known as relevant drug targets were annotated (red lines) (FIG. 1a ). We examined expression of vasculogenic/angiogenic pathway members by RT-PCR in ABCB5⁺ MMIC. Results of this anaylsis are shown in FIG. 1b . We used dual color flow cytometry using ABCB5 phenotype-specific cell gating to determining FLT1 (VEGFR-1) protein expression of ABCB5⁺ MMIC (FIG. 1c , top) and ABCB5-melanoma cells (FIG. 1c , bottom). We examined CD144 expression in ABCB5⁺ MMIC or ABCB5⁻ melanoma cell subpopulations by immunofluorescence staining prior to (t=0 h) and upon 48 h of culture (t=48 h) in the presence of 100 ng/ml VEGF¹¹. Representative immunofluorescence staining for CD144 expression (Texas red) are shown in FIG. 1d , with nuclei counterstained in blue (DAPI). Mean percentages (mean±s.e.m., n=3 replicate experiments) of cells staining positively for CD144 in each sample are shown on the right. We examined CD144 expression in melanoma cells in the presence of 100 ng/ml VEGF as in above, but in the presence or absence of anti-FLT1 (VEGFR-1) blocking mAb or isotype control mAb. Representative immunofluorescence staining for CD144 expression (Texas red) by melanoma cells cultured for 48 h (t=48 h) are shown in FIG. 1e , with nuclei counterstained in blue (DAPI). Mean percentages (mean±s.e.m., n=3 replicate experiments) of cells staining positively for CD144 in each sample are shown in the far right panel. We examined tube formation by phase contrast light microscopy of melanoma cells cultured for 24 h (t=24 h) in the presence of 100 ng/ml VEGF and the presence or absence of anti-FLT1 (VEGFR-1) blocking mAb or isotype control mAb (FIG. 1f ). Number of tubes/microscopy field (mean±s.e.m., n=3 replicate experiments) and tube length (μm) (mean±s.e.m., n=3 replicate experiments) are illustrated for the different experimental conditions on the far right panels, respectively. We examined the differentiation potential of ABCB5⁺ and ABCB5⁻ human melanoma cells along a adipogenic pathway (FIG. 1h , Oil Red O staining, nuclei are counterstained with hematoxylin) and osteogenic pathway (FIG. 1i , Alizarin Red staining). Myogenic differentiation potential of ABCB5⁺ and ABCB5⁻ human melanoma cells was also examined (FIG. 1j ). Absence of myogenin staining (FITC, green) was detected in ABCB5⁺ or ABCB5⁻ human melanoma cells (nuclei are counterstained with DAPI).

Example 6: MMIC-Driven In Vivo Vasculogenesis

We investigated MMIC driven vasculogenesis in vivo. Sections of human melanoma growing at melanoma cell injection site within human dermis of skin xenograft to NOD/SCID mouse were conventionally-stained by hematoxylin and eosin (FIG. 2a ). We also examined by immunohistochemistry the expression of human CD31 which indicated angiogenic response at perimeter of melanoma within human xenograft. (FIG. 2b , broken line represents interface of tumour nodule with dermal connective tissue). We used periodic-acid Schiff (PAS) stain (with diastase), an immunochemical stain of CD31-negative interior regions of melanoma xenografts, to reveal numerous anastomosing channels (FIG. 2c , inset is laminin immunohistochemistry indicating identical pattern). We conducted transmission electron micrographs of interior regions of melanoma xenografts (FIG. 2d ), and found that lumenal spaces containing blood products (erythrocytes) are lined by melanoma cells and associated basement membrane-like extracellular matrix. We examined the interior zone of melanoma xenograft derived from cells expressing GFP transgene and immunohistochemically stained for endothelial marker CD144 (red chromogen); results are shown in (FIG. 2e ). We found that CD144 expression is confined to cells forming lumen-like spaces lined by cells that co-express GFP and CD144 (indicated as yellow-orange). We also performed immunohistochemistry, at low (FIG. 2f ) and high (FIG. 2g ) magnification, for ABCB5 protein; our results show that reactivity is restricted to anastomosing channels identical to those seen in FIG. 2c . The inset in FIG. 2f depicts similar formation of ABCB5-reactive channels in a patient-derived melanoma biopsy. We performed in situ hybridization for ABCB5 mRNA (FIG. 2h ). Our results reveal a channel pattern corresponding to that of ABCB5 protein expression (compare with FIG. 2f ; inset is sense control). We examined the expression of ABCB5 in melanoma xenografts after intravenous administration in vivo (FIG. 2h ). Detection of anti-ABCB5 mAb was accomplished using anti-mouse Ig immunohistochemistry; note localization to channels (inset represents anti-mouse Ig staining after intravenous administration of irrelevant isotype-matched control mAb). Dual-labeling immunofluorescence microscopy was performed for both ABCB5 (green), CD144 (red), and ABCB5 & CD144 (mix) (FIG. 2j ) and ABCB5 (green), TIE-1 (red), and ABCB5 & TIE-1 (mix) (FIG. 2j ).

Example 7: Interdependency of MMIC-Driven Vasculogenesis and Tumourigenesis

We examined ABCB5 expression by flow cytometry; ABCB5 or control staining (FITC, F11) was plotted against forward scatter (FSC) for human A375, MUM-2B, and MUM-2C melanoma cell inocula. Representative data is shown in FIG. 3a . We examined histologic sections of melanomas that developed from three unsegregated and ABCB5-depleted melanoma cell lines injected intradermally into human skin xenografts. Representative sections are shown in FIG. 3b . We used histology to determine tumour formation rate (%) 3 weeks following intradermal transplantation of unsegregated vs. ABCB5⁺-depleted human A375, MUM-2B or MUM-2C melanoma cells (2×10⁶/inoculum) into human skin/Rag2^(−/−) chimeric mice (n=5, respectively). (FIG. 3c ). We determined histological tumour volumes (mean±s.e.m.) 3 weeks following intradermal transplantation of unsegregated vs. ABCB5⁺-depleted human A375, MUM-2B or MUM-2C melanoma cells (2×10⁶/inoculum) into human skin/Rag2^(−/−) chimeric mice. (FIG. 3d ). We performed immunohistochemistry for laminin. Our results showed the extent of channel formation in melanomas that developed from unsegregated or ABCB5⁺-depleted melanoma cell inocula derived from A375, MUM-2B or MUM-2C lines injected intradermally into human skin xenografts (arrows=necrosis). (FIG. 3e ). We performed image analysis of laminin immunoreactivity for melanomas derived from unsegregated and ABCB5⁺-depleted cell inocula. Data are shown in FIG. 3f ; y-axis is percent of pixelated area with reactivity (mean±s.e.m.); solid bar represents tumours derived from unsegregated melanoma cells, open bars represent tumours derived from ABCB5⁺-depleted cells (A375, P<0.0032; MUM-2B, P<0.0005; MUM-2C, P<0.0059).

Example 8: Correlation of ABCB5 Protein and mRNA Expression Across Human Melanoma Cell Lines

We examined ABCB5 and tubulin expression in a panel of human melanoma cell lines by western blot analysis (FIG. 4a ). We examined relative ABCB5 mRNA expression (log 2) in a panel of human melanoma cell lines plotted against ABCB5 protein expression as determined by ratios of ABCB5 89 kD western blot band intensity and tubulin western blot band intensity for each human melanoma cell line. (FIG. 4b ). Data points are as follows: 1, SK-MEL-2; 2, SK-MEL-5; 3, SK-MEL-28; 4, MDA-MB-435; 5, UACC-62; 6, UACC-257; 7, M14; 8, MALME-3M. Spearman Rank Correlation r (corrected for ties).

Example 9: CSC-Associated Genes Identified at the Protein Level

Using cell surface immunostaining and flow cytometry we identified additional genes to be differentially regulated at the protein level in ABCB5+ CSC versus ABCB5− cancer bulk populations. These are all immunomodulatory molecules and the ones upregulated in ABCB5+ cells may be relevant to the escape from immunosurveillance and be resposible for resistance to immunotherapy in malignant melanoma, i.e. when the genes overexpressed on ABCB5+ cells are targeted, melanoma is predicted to be sensitized to immune attack and therapy.

TABLE 8 Upregulated in ABCB5+ CSC compared to ABCB5− bulk cancer populations: MHC class II CD28 CD86 PD-1 CD40-L 4-1BB-L B7-H4 GITR

TABLE 7 Downregulated in ABCB5+ CSC compared to ABCB5− cancer bulk populations MHC class I CD80 PD-L1 ICOS-L

REFERENCES FOR DETAILED DESCRIPTION AND EXAMPLES

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Having thus described several aspects of at least one embodiment of this invention, it is to be appreciated various alterations, modifications, and improvements will readily occur to those skilled in the art. Such alterations, modifications, and improvements are intended to be part of this disclosure, and are intended to be within the spirit and scope of the invention. Accordingly, the foregoing description and drawings are by way of example only. 

1. A method for diagnosing cancer in an individual, comprising: determining an expression level of a cancer stem cell (CSC)-associated gene in Table 5 in a test sample from the individual; and comparing the expression level of the CSC-associated gene to a reference value, wherein results of the comparison are diagnostic of cancer. 2-21. (canceled)
 22. A method for isolating a cancer stem cell, comprising: contacting a sample with an agent that binds a polypeptide encoded by a CSC-associated gene in Table 4, wherein the polypeptide is expressed on the surface of the cancer stem cell, and wherein, if the sample contains the cancer stem cell, the agent binds to the polypeptide; and isolating the agent from the sample. 23-31. (canceled)
 32. A method for treating an individual having, or at risk of having, cancer, comprising: administering a therapeutically effective amount of a composition that induces the expression of a CSC-associated gene selected from the group set forth in Table 2 or
 7. 33-42. (canceled)
 43. A method for treating an individual having, or at risk of having, cancer, comprising: administering a therapeutically effective amount of a composition that targets a product of a CSC-associated gene selected from the group set forth in Table 1 or
 8. 44-65. (canceled)
 66. A method of delivering a therapeutic agent to a cancer stem cell, comprising: contacting a cancer stem cell with an isolated molecule that selectively binds to a polypeptide encoded by a CSC-associated gene selected from the group set forth in Table 4 conjugated to a therapeutic agent in an effective amount to deliver the therapeutic agent to the cancer stem cell. 67-75. (canceled)
 76. An isolated molecule that selectively binds to a polypeptide encoded by a CSC-associated gene set forth in Table 4, and that is conjugated to a therapeutic agent.
 77. The isolated molecule of claim 76, wherein the CSC-associated gene is selected from the group consisting of: ANK2, NCKAP1L, PTPRE, PTPRS, SBF1, SCN3A, SGCA, SGCB, SLC2A11, SLC2A8, SLC4A1, STX3, and TBC1D8.
 78. The isolated molecule of claim 76, wherein the therapeutic agent is selected from: a toxin, a small-interfering nucleic acid, and a chemotherapeutic agent.
 79. The isolated molecule of claim 76, wherein the isolated molecule is an antibody or antigen-binding fragment.
 80. The isolated molecule of claim 76, wherein the isolated molecule is an isolated receptor ligand of the polypeptide.
 81. The isolated molecule of claim 79, wherein the antibody or antigen-binding fragment is a monoclonal antibody, polyclonal antibody, human antibody, chimeric antibody, humanized antibody, single-chain antibody, a F(ab′)₂, Fab, Fd, or Fv fragment. 82-84. (canceled) 